DERR-2024-006291

Adjustment Tracking Form
e s
ler 5
FAC # lo@t1 t
FACILITY NAME:
OWNER NAME:
(circle one)
REASON FOR:WaiveAdjustment Refund
7s eA(.o
eo r
e s,
q F'ce $
I qb7.?b
$ t4tt.zo
o 0 u
RE-BILL?Yes
BY:DATE:
APPROVED BY:2-b
4 o2-
UNDERGROUND STORAGE TANK PROGRAM
dlr
(No)
nEe,EivED
JuN 0 3 2002
oEo
& Bsmeolr$oil0nt8
6 LA
Wz4.az
Ss7:fu ,v77v?d-ffi.
Cl) Zaf- taa 4-ZZ aal =8a Azzzzia./zl/a/cd
UNDEHGROUND S, dRAGE TANK PERMANENT CLOSURE N- flCE (Revised 01/01/97)
Facility tD#
Closure Notice prepared request of the owner/operator (identified below) by
Phone*(?trl 1 a67r?-the
of (company
Address Zp *z:-
FACILIrY INFORMATION
Tank Phone #€oA7"- %4
[ ] sole proprietorship [ ] partnership f(corporation
State Use
in LUST File #
s to LUST Review
ST Status
Contact person
Number of regulated tanks at the facility before closure: J-
Number of regulated tanks at the facility qftgl closure:3-
TANKS CLOSED
' tndicale the specifc substance stored in each tankto be dosed (regular, unleaded, desel, waste oil, etc.)
Name /
StateTfl
Phone #&?/,, *- r aP
CerL #m0/5?ery.
Phone #
Vzzz state // zip tfd44
Cert. #cstt{v Exp.v7 7/€Name
1
Tank #I ?-J b/6-
Date lnstalled ?fr UI t/F AA Ar<
Capacity /t //?///a/Zrdr){da/Uea)
Substance stored'&$@s ,Orbrg l?r"Ea,/&rs
Date last operated Mrs4z rfr/a ,tUbS l,bthZ ,t/rzbz
Date closed ft-r/t &#l %dz lzidt fu.,
How closed
(Removed/ln place)
a
lbpatl rfuat*l tTfr-rr-,-Tc
7(ez*-Z 's/eantn
-r'
Phone #
zip-?t6€
2
f,* Z= t
Date Processed bv
Date Mailed to LHD
Michael O. Leavitt
Govemor
Dianne R. Nielson, Ph.D.
Executive Director
Kent P. Gray
Dircctor
DEPARTMENT OF ENVIRONMENTAL QUALTTY
DIVISION OF ENVIRONMENTAL RESPONSE AND REMEDIATION
168 Nonh 1950 West
P.O. Box l448ut0
Salt L:ke City, Utah 841 14-1340
(80r) s36-4100
[phone] Fax
[phone]T.D.D.
www.deq.state.ut.us Web
ERRL-1283-00
July 6, 2000
Max Eggertsen
Maetex Supply Company, Inc
700 South University Avenue
P.O. Box 450
Utah 84603
Former Maetex Supply, Texaco, located at 815 West 1200 South, Orem, Utah
Leaking Underground Storage Tank (LUST) Site Closure
Dear Mr. Eggertsen
The case file for this facility has been reviewed b1, your state project manager, who has
recommended that no further corrective action be taken at this time. This no further action applies only to
the specific LUST release EKFD. This recommendation is based upon the information contained in the file
supplied by you or your consultant.
The information you have submitted indicates that any detectable petroleum contamination at the
site is not a threat to human health or the environment as characterized using State Underground Storage
Tank Rules. In the future, if other evidence indicates a spread of contamination from the Facility which may
cause such a threat, further corrective action may be required.
If you have any questions regarding this matter, please contact Bruce Hagans, your DERR Project
It{anager, at [phone].
Sincerely,
| ,,a
L
Kent P. Gray, Executive Secretary (UST)
Utah Solid and Hazardous Waste Control Board
KPG/BHIVstt
Joseph K. Miner, M.D., M.S.P.H., Director, Utah County Health Department
Mark Ellis, Ellis Environmental Services, lnc.
D,
I INNFEll:EInI I ND C'. , .clA':F TANI' DFAI'ANFNT l:I /rcttEEt. -t-E (Revised 01/01/97)
Facility tD#
/,A
UU
Closure Notice prepared the request o, the owner/operator (identified below) by
o, (company enone*tfztrl )7? 62/5^
Address &z State r'/zip fl?zzu-
FACIL]TY INFORMATION
Tan k Owner 2. &:pha e#&/\ ?zr-fuf/
[ ] sole proprietorship [ ] partnership f( corporation %oa sra*,t zip4y'6t2tL-Address 7lZ> *uZ/- 4/,8.c
Fac|ifiy Nalf/E A?kd A zr/2 / /22 -
a .-t>
Contact person
-22 b
amples to LUST Review_
UST Status
State Use O
amp les in LIJST File #
ate Mailed to LHD
ate Processed
Number of regulated tanks at the ,aaility before closu re: J-
Number of regulated tanks at the facility after closure: d
TANKS CLOSED
' lndicate the specific substance stored in each tank to be dosed (regdar, untead€d, desot, wasts cil, etc.)
Name /
z.o
Cert. #
Phone #
rart/5?Ew . date
Address
Compa
Name
7n-t.l State-J2L Zp
cer. *cs0L(7 exp.aateZL@
7Vr Z zrs'Phone # (VAA"
Tank #z.J L-/I
I I
Dale lnstalled 3k ul 06 OA /A-
Capacity /l/?i,D//)//4ry fda/I a?lazt
Substance stored &?r'@1 P,bsz r7,.ba,/br .rni=
I
Date lasl operated ra,*/aZ rtrz/a ,aZv/az ,,i*t/zz t*zbz E
Lrrl
Date closed a/a,r'/z*t 1/-rzz Z/zdz d-lrzn -zo
How clos€d
(Removed/ln place)t*lru/tfazt*t 'y'r-rr-o /n*t -7 '/etstt
EII
EIIHI
Address c salgf zi 3
t'7 I
f,"' 1 ,'
ctty -2,* /e- sl(a,€ -A- zip -@
ptune#&22/\ 4?A+%?4
5-
co
f'+
1
Tank was: I I Purged [ ] lnerted. Method Used:
[)dTank was. cleaned.
Ea/a" A'-/
Location of Closure Records
For ln-Place Closure: tanks lilled with
ls any contaminated soil which was over-excavated still on-sle?
Was Free Product encountered during closure acffilies? / !
S]TE ASSESSMENT
ACdress
-Yes
No Not applicable
lf yes, please indicate thickness,
-lnchesComplete the Facility Site Plat (Closure Notice) and Sample lnformation Table (Closure Notice) on pages 3 and 4 to show the
locations, depths, and other intormation on all soiUgroundwater samples taken for closure. The samples must be consistently
identiJied by sample lD # on the site plat, table, and lab analysis report.
[$l Completed Facility Site Plat (Closure Notice) is attached.( The lollowing must be included (enter the distance, and direction (N,S,E,W) lrom the area ol contamination or, where applicable,
use OH lor overhead, NP for not present):
, _Waler Line _Sewer Line _ tlatuEl Gas _ Slom Orain _Tdephona _ Eleclrical
-
Propsrty Une
-
Buildings
[]4 Completed Sample ln{ormation Table (Closure Notice) is attached.
tX Certified lab analytical environmental sample results are attached.
[}{ Unilied Soil Classificalion (USC) sample results are attached.
[l Chain of Custody form is attached.' Samples were properly: t dcollected t)+ Labeled []iFackaged lr{Transported
lyl[ Samples were in sight ol lhe'person in custod9 at all times or in a secued lock& place.
(
I certily under penatty of law that the closurc slte assessment at thls lacility was conducted ln eccordance with R311-
fr2(pafis2m.5,zand 280.?2) and R311-Z)S UA.G. and that any additlonal samples rcquir€d by R31t-Ar2 parts 280.52
and 280.72 and R311-20t2(axl) were properly collected.
Signature of Certified Groundwater/Soil Sampler
Full name of Certilied Sampler OE Date
lf contamination at the ,acility is confirmed, any person providing remedial assistanc€ lor a fee must be a Certified UST
Consultant. The Certi{ied UST Consultant providing assistance is:
CERTIFIED UST CONSULTANT Name /r{Cert. f CC Exp. date_
Company Phone #
Location Narne Contact Name Phone #Oate Amount
hil.,fank# -f-Tank(s)HZs f,)-z
(ftFZ'.- galProduct From Tank(s)lhte
9tW-Contaminated Water From Tank Cleaning nu/i*,u d,Fl/7$'gal
'--- galSludge
Contaminated Water From Excavation ,(l,arz gal
Contaminated Soil rtlt.tt,*yd3
2
State-
cLosuBE INFoRMAT|ON \_
!f Fuel was emptied /d StuOOe was removed
For Change-ln-Service: Substance to be stored
DISPOSAL SITES USEO:
I
fAClLlTY SffE PLAT (GLOSURE NOTll ,
The site plat must be drawn to an appropdate identified scale. lt must show actualsampling locations, substances stored in tanks, and
other relevant information. Tank and sample identilication numbers must be consistent with the inlormation given on p. 1 and 4 of the
closure notice
Facility lD#Drawn
1I Scale: 1" = _Feet
NORTH
'f4ff1 ufa
r
r t{f t 5,/
i
I
I
X = Sanple locations (SS-f, WS-#, USC-')
A = Monitoring Wells (MW-r,)
O = Soil boring (SB+). or Geoprobe Bodng (GP-*)
a = Water Wells (domestic. livestock. etc.)
Slope ol Sur{ace Topograph},: (N. NW, W. SW. S, SE. E. NE)
tend Use Al Site: _Residential _ Commercial _ lndustrial
Sunounding tand: _Residenliat _ Commercial _ lndustrial
Site Plat llu3t lndacrtc Actual Locations Ol:
t Cufient & ,omer tanks, dping & disp€nsers
rz Excavations, GW rnonitoring wells & soil stockpiles
rz l-ocafon & depth ol atr safiples taken
r/ B.uildi.rgs. rorccs, & prop€fiy bouft,aries
o/ Utility clnduil5 (sesers, gr.is, waler. sto.m
drains, electrical etc.)
./ Oepth to groun6rater (il encountered)
3
Sample #/Lrb lD Sample
typet
Depth"Compounds!
fitl,?a/a",il/tratl-rtaffir2 1162
{a.a,tl/ rs 5T 7//)
ftiF,rr/il z ul,//.l/
/,F,u/ilzs df 7///
I
II
I
Viipue tNroRManoN rague tcto"rr"J,l\-oti""t
Complete table ,or all samplas that wEre taken for closurc. Semple lD numbcrs on the table must be consistent wlth (
the sample lD numbers given on the site plat and in the lab analysls rcpoa.
1 Soil (SS), Groundwater (GW), or Unified Soil Classlfication (USC).
2 Final depth (in feet) below grade at which samples were taken.
3 Contaminant compound(s) analyzed ,or each sample CrPH, BTEXN, O&c, etc)
4 Appop.iate snalysis melhods ror contamlnanl compound(s)each ssmple (6015 mod., 8020, 4t3.1, etc).
Slate Certif ied Laboratory used
Contact person /f/c //.d/Ptrlne*(f,r'A ?P5-ZfiAAt./
Please erglain any (n(*dt
"o"nuating
circumstances
n/D,tzF
encountered during the site assessment or closure:
information on this lolm and that it is true,
were followed during tank closure.
and clmplete and further, that the procedures described herein
Signature ol UST Owner
Full name o, Owner oate?-9-&
Retum completed F Ftat Saffteewormation Table, Soiycroundwater sample lab analysas
results, USC sample results, and Chain of Custody form within 90 days of UST Closure to:
State of Utah Dept. ol Environmental Quality
Division of Environrnental Response and Remediation UST Section
P.O. Box 144840
'168 North 1950 West
salt Lake city, urah 841 14-4840
4
Subslance
storcd in
tank
Analysis method(s)'
I certify under penalty o, law that I am the Own€r ol (tre tanqs) described above and that I am ,amiliar with the
RICHARDS
INDUSTRIAL
MICROBIOLOGY LABORATORY, INC.
55 East Center SL Pleasant Grove UT 84062 [phone] [phone] SLC [phone]
E-mail [e-mail] Website www. inconnect.com/-rimlab
Date Report Printed llednesday, July 19, 2000
PETRO ENVIRO
P.O. BOX51365
PROVO, UT 84605
Sampler: Steve Lyons
Phone: (801) 798€715
Fax:
SAMPLE SITE:
Lab Techs
AWAL
Iesl
BTEX'TPH'MTBE
Iesf Results MRL Method Sample Date: Time
Preparation
Analysis'See Attached Report
8260/8015 mod.
LaD lechs
AWAL
Iesf
BTEX/TPH'MTBE
MRL Method Time
t
Sample Date:
Preparation
Analysis
Completed
'See Attached Report
8260/8015 mod
Lab Techs
AWAL
Iesf
BTEX/TPH/MTBE
Iest Resulfs MRL Method
'See Attached Report
8260/8015 mod.
Lab Techs lesf
AWAL Unified Soi! Class.
E260/8015 mod
'See Attached Repod
Iest Resulfs MRL Method Sample Date:
Preparation
Analysis
Completed
Time
Lab Techs
AWAL
Iesf
BTEX/TPH'MTBE
Iesf Resu/fs MRL Method Sample Date:
Prepantion
Analysis
Completed
Byron Thomas, Lead Chemist
Richards lndustrial Mioobiology Laboratory, lnc.
Time
'See Attached Report
8260/80'15 mod.
Page I of I
Sample lD 2U6.9268 Southwest 9'
Received 713100
Reeiving Tem oC
z' -,<m/(
' '::: " a'
Sample Date -Tim 27-Jun{0 1 1:00
Completed
"'..Ree,fuitl8Tem o^
Iesf Resulfs
Sample Date: Time
Preparation
Analysis
Completed
ReceMPg Tem oc
55 East Center St. ptsasant crova UT SitO62 (8m),|5!t2lo (8Ot) 78s.25oo SLC (801035Eflail [e-mail] Web sile $^rw. inconnsctcom\_rimtab
Chain of Custody Report Subcontractors
Richards lndustrial Microbiology Laboratory, lnc
Dats and Time Sampled Source
American West Analyticat Laboratories
Tests Requested
BTEX/TPI-UMTBE
BTEXTP}UMTBE
Customer Name:
2348 9267
rv( :omp
Sample lD
2346.9268
Type:: comp
05/2712000 11:00:00 AM
# of Containers: 3
PETRO ETwlRO Southr,r€st i0
Note: 8260,/8015 mod.
PETRO Ei{VIRO SorthnBst 9,
Notq 8260/80t5 mod.
06/2712000 11:m:00 AM
# ofcontaineB: 1
5a
2346.9269
Typ€:: comp
2346.9270
Type:: comp
06/272000 'l2:20:00 pM
# of Cgntainers: 3
06272000 12:20:00 pM
# ol Contiainers: 1
PETRO ElwTRO Nortisast iO,
Note: 8260/8015 mod-
PETRO E}WTRO Nofteast 9
Note: 82608015 mod.
BTEX/TPIUMTBE
UnifedSoilClass. BTEX/TPIUMTBE
Jr.
L
(
Relinquished by:Date Timo Sampl€3 Received By:Dale Tim€Reasoo for Transter
T,anspoIt
? -f<trl
Pase 1 o, 1
RICHARDS
INDUSTRIAL
MICROBIOLOGY LABORATORY, INC.4tt2*
--J-
ru,'/
.4/zt r:7S{t oBsb l.0_)-sa, r6vr
qs>rrD ,ll /-,,
American West Analytical Labs
WORKORDERSummaT
Client ID:
Project:
Comments:
RIC 100
Petro Enviro QC LeYel:*F\'w
Srmplc ID Client Srmpl.ID Collcctior Drt.Drtc Received Drt. Due Mrtrix Tcrt Code Stor.gc
L41828-01A
L41828-0tB
L41828-024
L41828-028
L41828-03A
L41828-038
L41828-04A.
L41828-048
P-MBT)OTPH-W
BTX.PREP_W
TPH.W
P-MBTX/TPH.S
BTX.PREP
TPH.S
P-MBTX/TPH.W
BTX.PREP-W
TPH-W
P-MBTX/TPH.S
BTX-PREP
TPH.S
usc
2346.9267
2346.9268
2346.9269
2346.9270
6t27t00 ' 5tOO 7lt9t00
'7/t9t00
7^9lOO
1ngt00
7lt9t00
7lt9t00
7lt9t00
Tlt9loo
' t9l00
1^9tOO
't lt9to0
7^91O0
7n9t00
Watcr
Solids
Watcr
Solids
PurgeFridgc
btx
bb(
PurgeFridgc
PurgeFridge
PurgeFridgs
PurgeFridge
btx
bt(
PurgeFridgc
PurgeFridge
PurgeFridgc
2
I
L41828-04C
)
Page 1 ol1
05Jul-00
Work Order L41828
2
I
)
ORGANIC ANALYSIS REPORT
Contact: PeggyMcMcol
Analyzed: July 8,2000
Extracted: July 7, 2000
TPH.E
A
AMERICAN-
WEST
ANALYTICAL
I.A,BORATORIES
{53West3600 South
Saltlake Gty, Utafr
84115
Client: Richards Industrial Microbiology
Collected: lune2l,ZOC0
Received: Iuly 5, 2000
Analysis Requested: TPH by SWB0I5B
Lab Sample ID: L41828-O3B
Field Sample ID: 234G.9269
Site ID: Petro Enviro
Analytical Results
Units = mglL
Final Dilution Factor: I
Compound
Total Petroleum Hydrocarbon (DRO)
Reporting
Limit
Amount
Detected
5.0 220
(80.t)263-W
TollFree(888) 26r8f8fr
: , Fax(8Of;25L8ffi7
High surrogate recovery observed due to matrix interef,erenoe.
Released by:
Laboratory Supervisor
Rcport Datc:July 17,2000 Pagc I ofl
:'I5 t*:-tl'Il:nt' Prcmotion or !'t" t-ttty pJ'"G it*.J, o.in *n*"tion with rhe repubticarion of this report for rny purpo* orher ah.n for the rddresa wi, h.,,nlar ^nr., ^-
S
4a2 Nrf/lta,of /o'
,tdr
ORGANIC ANALYSIS REPORT
Client: Richards Industrial Microbiology
Collected: June 27, 2000
Received: July 5,2000
Contact: Peggy McNicol
Analyzed: July 10,2000
AMERICAN
WEST
ANALYIICAL
I.ABORATORIES
Analysis Requested: SW 8260B/5030A-MBTDOI/ToIaI Purgeable Hydrocarbons
Lab Sample ID: ,41828-03A
Field Sample ID: 2346.9269
Site ID: Petro Enviro
Analytical Results MBTDO{/TPII-P
(8,D26}8rf6
ToU rt€e (888) 2638585
hx (801) 2598587
Units = mg/L
Finrl Dilution Factor: I
Compound
Methyl tert-butyl ether
Benzene
Ethylbenzene
Total Xylene
Thc pH ofthc sample was >2.
Rcleased by:
Reporting
Limit
Amoutrt
Detected
0.0020 < 0.0020
0.00r0 0.0034
0.0020 < 0.0020
0.0020 < 0.0020
0.0020 < 0.0020
Laboratory suPervisor Rcpon Date: Jury l7,2o0o Pagc r of r
;fi;I;;[;.;;,;.;il;;;;;t;;;i;;'*;.; h -**,i* *irh th. Fpubrk rion of rh; nfrn ioriry pureo* ortrar rhrn {or rh!.ddr6... w'rrb. ttmt.d oirv on
-i*r rti. -p.ny
i.-pt ao -po.uiliuti.i,c.p r.iti" J* i..1"...*, o ^p..n- rni/or rdy.i. i. sood-f.irh.,td.@rars lo th! rul6 ol rh. rr.d..nd of *ie'r.t'
46Ei West 3600 South
Salt lale City, Utatr
&111:i
Toluene
Client Richards Indnstrial Microbiology
Collected: ltne 27, 2000
Received: July 5,2000
Analysis Requested: TpH by swgolsB
1
Lab Sarnple ID: L4lg2g-O2B
Field Sample ID: 2346.9269
Site ID: Peto Enviro
Analytical Results
UniS = mg/kg
Final Dilution Factor: 1
Compound
Total PeEoleum Hydrocarbon (DRO)
/f/ tVi/ a?71tr//t/42/ -/
Contact: Peggy McNicol
Analyzed: July 11,2000
Extracted: July I l, 2000
TPII.E
AMERICAI{
WEST
AI\TALYTICAL
I.A,BOR.A^TORTES
463 West 3600 Sout(
Saltlake Gty, Utah
84115
(80.t)?sw
ToUFree(888) 26}8ff!f
Fax(801) 26UW7
Reporting
Limit
Anount
Detected
<2020
Thir report is prcvided for thc .xclualvc u
i',ffffiff: recovery observed in Lcs and MS/MSD. Data deemed acceptable as spike recovery was
Rcleased by:
Laboratory Supervisor
Report Date:July 17,2000 page I of t
the me of lhir omprny or .ny membcr of its stafI. or rcproduction of thiswith tha tdverti*menl, prcmotion or lla of,of thr rddser*G. privileges of rubrqrnt E oI
.my product or proes, or in connstion with thc epubllcetion of thiJ rcfr rr for my purpo* oth€r thtn for thc eddgw will
in connection
ORGANIC ANALYSIS REPORT
f/ Ar,/ - go"i/tr ,.,ot X'
Client: Richards Industrial Microbiology
Collected: June 27, 2000
Received: July 5,2000AMERICAN
WEST
ANALYIICAL
I,.ABORA:IORIES
{53 West 36(X) South
Salt take City, Ubh
84115
Analysis Requested: SW 8260B/5030A-MBTHO.I/ToIaI Purgeable Hydrocarbo:
Lab Sample ID: L4182842A
Field Sample ID : 2346.925E
Site ID: Peho Enviro
Analytical Results MBTDG{/TPH-P
Unis:mg/kg-dry
Final Dilution Factor: 2.56
Comoound
Methyl tert-butyl ether
oZ Moisture:
Amount
Detected
10
(g)1) 26$8585
ToU &ee (888) 26&8686
Frx (801) 25&8687
Benzene 0.0026 < 0.0026
Toluene 0.0051 < 0.0051
Ethylbeuene 0.0051 < 0.0051
Total Xylene '0.00s1 < 0.0051
Rcleased by:
Laboratory Supervisor July 17,2000 Page I of I
co.r6.cl TN, o o..y ..eet! no dDoilibility .ropt io. lh. .lu. D.r6or!|.e ol ldp..tid .nd/or . ly.ir ir so.' 'h .nd ...ording io lh. rulet of lhe lt.de .nd of ki.@
Contast: Peggy McNicol
Analyzed: July 10,2000
Reporting
Limit
0.0051 < 0.0051
Rcport Datc:
#/ r'r&/ fudlt€a* /O,
Client Richards Industial Microbiology
Collected: June 27, 2OOO
Received: July 5,2000
Analysis Requested: sw 82608/503 oA-MBTHol/Total purgeable Hydrocarbons
Lab Sample,ID: L4l 828-0lA
Field Sample ID: 2346.9267
Site ID: Peto Enviro
Analytical Results MBTE)C..{/TPH-P
Units = mglL
Final Dilution Factor: I
Compound
Methyl tert-butyl ether
Contact: Peggy McNicol
fuialyzed: July 10,2000
AIvTERICAI{
WEST
AI{ALYTICAL
TABORAI'ORIES
463 West 3500 Southl
Salt,Lake City, Utatr. 84115
Reporting
Limit
Amount
Detected
0.0020 < 0.0020
(8p/t)26tw
ToUFree(888) ?SW
Fax (801) 26}8fB7
Berzene 0.0010 0.0021
Toluene 0.0020 < 0.0020
Ethylbenzene 0.0020 0.00a
Total Xylene 0.0020 < 0.0020
Released by:
Laboratory Supervisor
Report Date: luly 17,2000 page l.of I
with the tdverti*mcnt, DDmotionF^ikr-. fti.-----..:---.--"orrleo.fenyPrcductorPEs,iri"omcaim*id,h;;;;;ii..,.noftNsremrrior.nvourmenrha,ihrnr^.lr--rri----i...:,,;-----.,
Ar
The pH ofthe sample was >2.
\-
ORGANIC A}IALYSIS REPORT
F t /J/L[L/ /r2ff7/,"''i7 r' y'
Contact: PeggyMcNicol
Analyzed: July 8,2000
Extracted: Iuly 7,2OOO
T?H.E
AMERICAN
WEST
AI{ALYTICAL
IJ,BORATORIES
Client: Richards Industrial Microbiology
Collected: lune?7,20Co
Received: July 5,2000
Analysis Requested: TPH by SW80l5B
Lab Sample ID: L41828-0lB
Field Sample ID: 2346.9267
Site ID: Petro Enviro
Analytical Resultsrttiit West 3600Souttr
Saltlake City, Utah
84115
(nD26}8r8f,
TollFlee(8881263*fB6
Fax(80r) 263*68.7
Units = rng/L
Frnal Dilution Factor: I
Comoound
Total Petroleum Hydrocarbon @RO)
Reporting
Limit
Amount
Detected
< 5.05.0
Released by:
Iaboratory Supervisor Rcportlhro:July 17,2000 Pagc I ofl
Thb Eport is prcvided for.thG Gxclusiyc u of the eddms. Privilegec o,f ubreqmt e o, th€ um€ of thir mprny u-uy memb€r o, itt 3t.ff, c rcProducti,on of thir.rcport in comtion
with gi edveirierent, promtim or ..L of rny produt s prcccr. i in conutim with thr epubllcrtion of thii rcpon for uy purpcc oth.r th.n for thr rddroe will be grnted only on
mtrrct. Thi3 mmpuy iceptr no oponalUttity irept tor tir duc perfumre of inrpcction eni/or mlysb in g@d f.ith rtd .aordint to the rula of thr tredc .nd o, rirre.
Client Riohards Industrial Microbiology
Collected: June 27, ZOOO
Received: July 5,2000
Analysis Requested: TpH by SWg0lsB
Contacr Peggy McNicol
Analyzed: July I I,ZOOO
Extacted: July I l, 2000AIvTERICA\I
WEST
AI{ALYTICA,L
I.A,BORATORIES
rt63West3500 South
Saltlrke City, Utah
84115
Lab Sample ID: L4l82g-04B
Field Sample ID: 2346.9270
Site ID: Petro Enviro
Anaffical Results
TPH-E
Units = m/kg
Final Dilution Factor: I
Compound
Total Petroleum Hydrocarbon (DRO)
Reporting
Limit
Amount
Detected
<2020
(801) 25&8686
ToIt Free (888) 26}86f6
Fax(801) 263Hf/ii7
High surrogate recovery observed
}ffiTilff: recoverv observed in LCS and MSiI\,fsD. Dara deemed acceptable as spike recovery was
Released by:
Laboratory Supervisor
Report Datc:luly 17,2000 page I of I
1 #"t l&taof 7/
\-
ORGANIC A}IALYSIS REPORT
#* rt/rz /7aaof q,
Contact: Peggy McNicol
Analyzed: July 10,2000
Client: Richards Industial Microbiology
Collected: June 27, 2000
Received: July 5,2000
AI\4ERICAI{
WEST
AI{ALYIICAL
I.ABOR.AIORIES
Analysis Requested: SW 8260B/5030A-MBTDOI/ToIaI Purgeable Hydrocr )ns
Lab Sample ID: L41828-04A
Field Sample ID: 2346.9270
Site ID: Petro Enviro
Anatytical Results MBTEXIVTPH-P453 W*st 3600 South
Salt La&e City,Utah'
84U5
(801)263*6B6
Tollk€e(888) %W
h'(80r) 26}8f/d,7
Units = mglkg-dry
Final Dilution Factor: 2.56
Comoound
Methyl tert-butyl ether
Benzene
Toluene
Ethylberzene
Total Xylene
Reporting
Limit
7o Moisfure:
Amount
Detected
4
0.0051 < 0.0051
0.0026 < 0.0026
- 0.0051 < 0.0051
0.0051 < 010051
0.0051 < 0.0051
\ c,tReleased by:
Laboratory Supervisor Report Datc:
itr 3t [f. o,
oth.r tlun
July 17,2000 Page I of I
rcproduction o, this rcPort in coffitim
for thc rddras will bG gnnt.d only onThir nport is prcvided lor the crcluiyc ur. o, th. .ddm. Privile6es ol ubcq@nl u o, thr Bmc of thir ompeny or rny m:nber of
witi tlp edvcitirnent, prcmtl,on or r.t of rny prcduct ff prM, tr in sturaction with th. t?,public.tion o, thi. EPort bl .ny PutPo*
cqru.cL Thb ompmy iccpr r.o mponriUtlity ircpt for tir duc perfomue of iupcctim rnd/or rnelyrir in good frith end reording I!o th. ru16 of th. trtd. utd of Bi!N.
)
A ANALYTICAL REPORT
AMERICA}I
WEST
AI{ALYTICAL
L{,BORATORIES
Clienl Richards Indusnial Microbiology
Collected: Jun e 27, 2000
Received: July 5,2000
Analysis Requested: USC
Lab Sample ID: L41828-04C
Field Sample ID: 2346.9270
Site ID: Peto Enviro
Result
Contact: Peggy McNicol
Analyzed: July 14,2000
USC{53West3600 South
Salt rake City, Utah'
84115
(801) 25$86S5
TollFree(888)263.W
, Fax(n\ZShW7
Uniform Soil Classifi cation sw-well-graded sand with gravel
sufrRclcased by:
Laboratory Supervisor D^_-: h r__
ThL rePort is Prcvidcd tor tht Grctsive s of tlp eddrcsrc' Ptivileges of rubt quent us of thr Mme of thir o_mpany or.ny member of it3 strff, or rcproduction o, t6s npori in comtionH,ff.'*::m:*ltrj*I*.:[,:i:It*:":^T.l5::,*.::*:::Eii;;,b,i;.il;ari;l',:6;;;6;,-,.ilotr,rthan,qrherddrcwurbcg.ntedonyon
Tr{
RICHARDS INDUSTRIAL
MICROBIOLOGY LABORATORY, INC.qA+b
55 East Contd St. ! Pleasant Grovc, UT 84062 r 18001 453-lZlO r lS0ll 785-Z5OO r SLG: l80f l 355-5579
CHAIN OF CUSTODY REPORT
t/rztc Era/7r/&/<
SIJMPLER:1r7*{€
SAMPLE
NI.,MBER.DATE TIME
c
o
M
P
G
R
A
B
I'CATION
NT,MBEN,
OF
OONTAINENS N
Qr
N
\
\
$\
R.EMAR,I$
{4:62I //r?//t 3-v Y V /2r
*l f/tUa fi'a/v -fd u/q/,O/ts /X Y X vut:rL t*///L22 Y v v vM Er6/r$t J // / ''rir.
L frlo &;H /b/l tf /v v Y ,ry 7/#*!*Flt
&tl{ noc.l,{|ii)t
*o o Qzbcs
s tMPtlyrELrINQUrs HED BY :DATE TIME SAMPLES RECEIVED BY:DATE TIME REiibN FoR rnANsFEn
o7?o ftt/hl '/et oo oq"6/
IIIIIIIIIII (
V
Michael O. lravitt
Govmor
Dianne R. Nielson, Ph.D.
Exeutive Direor
Kent P. Gray
DiEtor
z\.
, .. *" " ..,..,. i , .- , ,,
DEPARTMENT OF ENVIRONMENTAL QUALTTY
DTVISION OF ENVIRONMENTAL RESPONSE AND REMEDIATION
168 North 1950 West
P.O. Box lzl4MO
salt Lake city, utah 841l4-484o
(801) 53s100
[phone] Fax
(801) 53644r4 T.D.D.
www.deq.state.ut.us Web
Ju,ly 26,2000
Dear Tank Owner or Operator:
The Underground Storage Tank Act specifies that yearly registration fees and Petroleum Storage
Tank (PST) Fund fees must be received 60 days after the due date. If they are not, the Certificate
of Compliance and./or coverage under the Fund automatically lapses.
Our records indicate that you have not paid your yearly registration fee and interest and/or your Fund
assessments and late penalties for the ,rmount indicated on the attached invoice. To continue to
maintain a valid Certificate and/or Fund Coverage, the past due assessments must be paid by
September 1, 2lX)0. If the past due fees have not been received by September l, 2000, the
Certificate and/or Fund Coverage will automatically lapse.
In the event you allow your Certificate and./or Fund Coverage to lapse, your tank(s) cannot receive
delivery ofproduct or be operated and costs ofinvestigating and cleaning up releases are no longer
covered by the PST Fund. Renewal of a lapsed Certificate of Compliance would require addidonal
time and considerable expense on your part.
Please return your invoice and a copy of this speed with your payment. If you have questions
concerning this matter or need any assistance, please contact Jason Wilde or David Wilson at
(801) 536-4iCrO.
State zip
Person
-sunounding
neighborhood: (check the best description of land use)
Owner Name
State
Facility Name
-Street
Address
Area Code Phone Number
rankuo. 4<TankNo. U[4 po.c?;-h*l_
c9 h,tok.toAloRloR1. Estimated S15S52.r'FRP,
GDG6G3. Substance Stored c6/d6a;/cwrs lcrrt4. Date last used
CY,:.;g- CI5f/-r*-6efn-.3R-6(-t'n-rB-d5ob-$-@4. Date Closed --lHn r..r\Prn.,c\Bnni.Agmi,A
5. How closed
ration Date:Ceil. #: GGW & Soil
Date:
UST
is on Site:of closure NNclosurer has an
Disposed at:2. Product removed:
Disposed at:N3. Sludge reqgYgd:-(
Rinsate disPosed at:4. Tanks cleaned:
LEL or %n obtained:re inside tank obtained bY:rlosive5
Removed, disPosal site:
6. Product lines were:
-
Cleaned,secured in Place,and capped
8. Soil7. Tank site:site:
PID or FID meter readings (indicate location on the site plat'):
Calibration sPecs
Meter T Gain or sPan
than 3 feetof contamination: 0-3 feet
1 Soil contamination is evident:
direction of sudaceto waterN2. Water contamination is evident: Y
3.#of Soilcollected:USC 4. Certified Lab:
O&G TRH HOC Othe
5.
observed collection of Y6.N lndicate location and of samples on the site Plat
and submitted them to the State Lab foricate S: Y
7. lnspecto r collected
8. Contaminated soil overexcavated:tf YNYNN/A confirmation samPles were collected
Date:
G
K5
K,
Yellow-lnspector,Pink-Facility/Owner Revised 5/98
Permanent Closure
ll. Location of Tank(s) -' trl. Ownership of Tank(s)
residential
_ Address
A
Tank No.\ )
TANKS CLOSED
ai/6o
ffi-,I'pt".e, cls)
Cert. #:TFl
1.
Methods
CLOSURE INSPECTION SITE PLAT
NORTH
Facil rD trto. /7
bdL
551
*a xs3 lo6tr)l
to6
ruQ
o.
x
-4
E
I
RR
I
PID or FID
I
,
oe
Potential Receplors: Distance (in feet) to the nearest:
Flesidences_ Commercialbuildings Propeny line_
Water line-
Storm drain
Surface water _ Underground: Sewer_
Telephone line_ Electrical line _
Active water well _
Natural gas line_
Other (specify)_
Comments
,n"o*,o,".,nn",r'1ffS0 )t"14, a-Q F8,..+.
( renh, day, y.!r, im.) -
ceniG9/5 Dare:aJardt{}f\-
LL.LK 6.0-c}n fi-r-I inch L certity that I inspected the above^named facility on
R lnspector, Pink-Facilily/Owner Revised s/98
I
*
E]
IFRI
Dropeneel-
\I$\O[\C\
I ///l7l
aFtodL
I,il
I
ENVIRONMENTAL MOTECIION
/^-rAr n
UIAl1 COUilTY HEALIH OPARIUE}IT
589 South State Street
Provo, Utah 84606-5056
" c re a.t in g h ea I t h.y co tnmun it ies
I
t
.loseph K. ltliner, M.D., t\4.S.P.H
Executive Director
ta
P
a
2
DIVISION OF ENVIRONIUENTAL HEALTH
Phone [phone] O Fax (B0i ) jT0-452i
Dwight C. Hilt, E.H.S. Director
Re:
March 07, 2OOO
Mr. Max A. Eggertson
Maetex Supply
70O South University Avenue
Provo, UT 84603
Closure Plan approval for closure of six UST's
Facility ldentification No. 1O001 71
Maetex Supply (Maxi Mart) 700 South University Avenue, Provo
Dear Max Eggertson:
The Closure Plan for the above-referenced facility received by the Utah County Health Department
on, March 02,2OOO, has been approved subject to the noted modifications, if any. This
department requires a fee of $10O per tank for the permit to remove or install, and $5O per
upgrade, including one charge each for removal and installation of lines, which can be obtained at
the above address within 72 business hours prior to closure or installation activities. This
department also requires you to schedule our inspector well in advance to be on site at your
closure or installation activities. The local fire department must be notified 72 hours before
beginning closure or installation and may have additional requirements.
The Closure Plan approval is effective for a period of one year from the date of approval. lf
closure does not take place within one year, submittal of a new Closure Plan will be required,
unless otherwise approved by the Executive Secretary (UST).
Any change to an approved Closure Plan must be submitted in writing and approved by our office
before implementation. lf contamination is suspected or found during closure activities, you must
report it to the Division of Environmental Response and Remediation (DERR) at [phone]
within 24 hours of discovery.
Enclosed is a copy of the "Closure Notice" form which must be completed and submitted to the
Executive Secretary (UST) Kent Gray, lgS0WNorthTemple, Salt Lake City, UT 841 14-4840.
Please submit the environmental and Unified Soil Classification (USC) sample analysis data and
Chain of Custody forms with the Closure Notice as soon as possible, but no later than 90 days
after tank closure.
lf you have any questions please contact Linda Luck at 37
DIRR
Since ENVIRONMENT,IL RqSPONSE & REMEDIATION
EI\TEREI)
r3:!C, HiII, E.H.S
Director, Environmental Health
DCH/LL
enclosures BY
cc: Gary Harris, Utah Division of Environmental Response and Remediation
Provo City Fire Chief
Petro Enviro
toldrz I
Closure Plan Review Summary
Facility lD 1000171
Number of regulated tanks at this site not previously closed: Database:
Certificate of Compliance lssued: Yes
TANKS TO BE CLOSED
Non-Notifier: No
6 Closure Plan: 6
Tank# Type Date Installed Capacity Substance Last Used RmvcUln place
1
2
3
4
5
6
Impressed Current Cathodic
Impressed Current Cathodic
Impressed Current Cathodic
Impressed Current Cathodic
lmpressed Current Cathodic
Impressed Current Cathodic
10000
10000
10000
10000
4000
2000
Gasoline
Gasoline
Gasoline
Diesel
Gasoline
Kerosene
IN USE
IN USE
IN USE
IN USE
IN USE
IN USE
REMOVED
REMOVED
REMOVED
REMOVED
REMOVED
REMOVED
TANK REMOVER
Name: STEVEN LYONS Cert. #: TR-TR-153 Exp. Datei t0At200O
SOI UGROUNDWATER SAMPLER
Name: STEVEN LYONS Cert. #: GSG&55L_ Exp. Date: 10fit2000
lf different from database:
Tank Owner: Phone:
Address: City: State: Zip:
Site Name; Phone:
Address: City: State: Zip
Remarks:
Original CP to LHD; Copy to G.H.; Copy Cover Letter to file; Entered D.8.2t25100; ARE ALL
6 OF THESE TO BE PULLED? VERIFY ON CP.
Friday, February 25, 2000 Page I of I
4/30t1985
4t30/1985
4t30fi985
4/30/1985
4t30/1985
4t30n985
LHD USE ONLY
Date Received
Reviewer
Date LHD Approved
Date mailed to State
Date Received
te Mailed to LHD
te Recerved From LHD
r/Date Approved
Review/Date
Closure Plan prepared at request of the owner/operator (identified below)by
of (company name 7t Phone # (?A ?*/Ft
Address P, fu.f/1/5-Citv ' €zip a//n€
A Contractor may prepare this Closure Plan as the owner/operato/s agent. ln preparing the Closure plan, the Contractor rr
act with the owner/operatods knowledge and approval. The owner/operator must sign the Closure plan.
This closure Plan is submitted in compitance with the requirements contained in R31'l-202 subpaft G and R31 1-204 (U.A.
FACILITY INFORMATION
I I sole proprietorship [ ] partnership !{Zorporation
gat*T zifu-
STATE NLY
State_ Zip-
Phone *tbtVz&*Contact pe
Total number of regulated underground tanks at this site
Total number of regulated underground tanks at this site to be closed
TANKS TO BE CLOSED
a
' lnc,icate the speciric substance stored in each tank to be closed (regular. unleaded, diesel. waste oil, etc.)
For waste oil tanks: Have degreasing or other types of solvents been stored or mixed with
Yes (identify if known)
+\-#-- No
-.Analysis lor lead or other contaminants may be required prior to disposal of contaminated soil
your disposal facility.)
Not kn{wn
Tank #/4f 3 7 {b
Date lnstalled r-.)
Capacity /2M2 /a@ /aaaz lfrdal zea i)
Substance stored'M &?f Gr€fl.baz k LIJ :
,l ,
Date last operated ht oG //dla /? aze /al dra td lhs I
{
Removed/ln Placel
Chanqe in Service?
:l <5EEhH
OatJ
(
t
UNDERGROUND STORAGE TANK CLOSURE PLAN (rev. 05/01/e8) FACILTTY D*M
Tank ownerfT : z, ,.2>. ^'c- phone * t&l l*d*
tu AtP "
Facility name -{.fuF
A z{d;aoa
oo
E'c4a
t"
L
lJ-
.:ta
2
Name C erl.
State flZ4.f
fuaa State t)?Zig #ad,
* ra d liV ero. aate Z/.i/il
Phone#(tru/\77? /F;.pCompany
Address Ci
o Name Cert. f G d .o^t"74*
Company
Address
/-2 Phone # (8a/\??? /Fs*
Ci
Before the closure plan is submitted ,or approval, the local health and tire departments where th6 lacillty is located
must be contacted' I he hcilit!, is in geavet, catbn, Emery, Gafield, Grand, l@n, Kane. sall Lake, San Juan, wasatch. or washington coaty @n',ct
DERR (USn at @0r)536-4100 instead ol the local healh distticl You stil must contact the local lte deoaftment in these countids.
CONTACT LOCAL HEALTH DISTRICT Name ol Dist.Date
Contact /;/,4 /2.,/Tifle Phone f ?2
CONTACT LOCAL FIRE DEPT. Name of Dept.
Contact
Date
Title Phone #
DISPOSAL INFORMATION
Tank(s) will be disposed at: Facility
eaaress fu/ f,i ,A*Z
Contact person
#aa
Vent lines
Plping will
Address
will either
be dispostl/ed at: Facility /kHbe:removed or cleaned and secured o pen.
tl Z*.,rd cvfuzi{.U-starc:ffifr%?e,/\fu/r#Phone #Contact person
Tank(s) will be emptled by: company
Tank(s) will be cleaned by: company
Phone #{l/t'pyron" 6 tfu4 C/-ffsy
Contaminated water in the tanldrinsate will be disposed at Facility t/r
Contact person
Tank(sl will be:ed or _ rendered inert by the lollowing method:
Phone #
Residual sludges will be disposed at the lollowing facil
^ddtess
/tz'/u lvl 4 ciry ,41 sor"-4hp
,'Hrl-r.r)z-/
Contact person t Phone # (344,trd F/*
FOB CLOSURE IN.PLACE ONLY
Facility Site Plat, Sample lnformation Table, sample results and Chain oi Custody forms are included.
Documentation that the tank(s) \,vere emptied and cleaned prior to sampling is included.
Approval for in-place closure has been granted by the Local Fire Oepartment.
Fire Dept._ Phone#Contact
I I Approval for in-place closure has been granted by the Local Health Department.
Health District
2
Phone#
t@/:'t *14r'W
Product lines will either be: --E- re^oveA or
-
cleaned, secured in place, and capped.
Oate
Contact_Date_
I I Substance to be used to fill tanks
II
tl
t1
I
l
I
!
I
I
t
ONTAMINATED MA TERIALS MUST B E D ts PO SED AT AN CCEPTABLE FACI L ITY:A
All malerials generated from UST closures must be managed and disposed in a manner that does not place those materii
in direct contact wrth the environment. On-site slockpiling of contaminated soils may be required prior to any soil managemr
activities. Any person providing remedial assistance lor a lee. including aeration and overexcavation (of more than iO yc
must be a Cedified UST Consultant.
SITE ASSESSMENT
A site assessment must be performed for all UST closures and change-in-service. Site assessments mustperrormed as outlined in R311-202, Par1. 280.72 and 8311-205 (U.A.C.).
s must b collected at th
encountered. a soil sample must be collected.n
and groundwater samples must be analyzed ,or the compounds shown in the tollowing table, us ing appropriate I
methods.
Contaminant Compounds to be Analyzed .{N-ALYTICAL
}IETHODS'
Soil. Groundwater
or Surface Water
Gasoline 8015 \Iodilied and
EP.A, 8020 or E260
Diesel Total Petroleum Hydrocarbons (TPH)l and Benzene. Toluene.
Ethyl benzene. X;"lencs. and Naphthalene (BTEXN)
8015 \lodificd and
EPA 8020 or 8260
IIsed Oil Oil and Crease (O&G) or Total Recoverable Petroleum
Hydrocarbons TTRPH): and Benzene. Toluene. Ethyl benzene.
Xylenes. Naphthalene TBTEXN) and MTBE: qld Haloeenared
Volatile Organic Co mpounds (VOC'st
EPA J l3.l or 418.1
rnd EPA 8020 or 8260
rnd EPA 8010 or 8260
New Oil Oil and Crease tO&G) or Total Recoverable Petroleum
Hydrocarbons (TRPH)
EPA -l l3.l or 418.1
Other or
Unkoown
Total Petroleum Hydrocarbons (TPH): and Benzene. Toluene.
Ethyl benzene. Yylenes. and Naphthalene TBTEXN): and
I Halogenated Volatile Organic Compounds (VOC's)
8015 \lodified and
EPA 8020 or 8260 and
EPA 8010 or 8260
lltcrnativ. methods or test proccdures stlowcd for 413.1 are 1664 or 5520(b), and 418.1 mry also use 1664 or j520(0. Thc DERR is r
accepting thc use of thc 6000 trleahod s€ries to replace the 600 rlcthod series for wrtcr ar|alysis. Note lhat snalytica-l nrthod nuobcrs uray cha
or be replrced (e.9., t020 can be upgraded to. or replaced raith. t260 lf desired. etc.). Check with rhe DERR. your ccrtilicd lrDpler, or y
anslyrical leborator,v if you have questiotts regarding the proper analyticd rnethod(s) to use for your sampling progra.o.
complete the Facility Site Plat and Sample lnrormation Table on pages 4 and 5 to provide site assessm.
information.
CONTAMINATIOII 1NES BI{ALIO N
lf contamination at the tacility is susoected or conlirmed, the information must be reported to the Executive Secretary (Ul
at [phone] within 24 hours. The Division ot Water Ouality must be notilied at (8Ol) 538-6146 if Free Produc
encountered or if sudace water has been impacted. lf contamination is conlirmed, any person assisting in the remediat
process for a lee must be a Certifiod UST Consultant.
3
Contamrnaled soils generated as part of tank removal are to be disposed at the lollowtng faciiitv:
dfl f '' Addrcsszrp rt. Uz/p. Zrl{ ciry ?kd)
statet'Zzip {4AO / contactpersonfa.y', C6bf4et phone* rftt t E=z-//-?tz
Su-bstance
or Product
Type
Total Petroleum Hydrocarbons (TPH): and Benzene. Toluene.
Ethyl benzene. Xylenes. Naphrhalene. TBTEXN) and MTBE
1I
NORTH
tr/,t
Scale: 1" -- -19
tlr
2 ry
4
A l,
,2/t/,r
flr/$,tr
u?r
IWfl
t?
/t
t 0{ ffa
f- w/-
7 tt
'u tt/lr- tt /
'r *, "'
?r.d-*..g[*+*-*-
elcctrical. clc )
4**'s,*#$;s,**-
5 ol the Closure Plan.
t/,
SAMPLE INFORMATION TABLE
Complele table for all samples to be taken tor closure
Approxjmale depth to groundwater in the vicinity of the tanks:f,1 reet.
Regional groundwater llow direction:dqf
State Certilied Laboratory to be used:fr,Zz/
Address .f/-EsdCeo/sr z7 Stats- cd-zpffiz
Sample #Oepth'a Compoundsr Analysis method(s).
tr/
gz
I GI'utfur'c
/-6-1,/of,
,fu Autt al t/
/a//al 5t////z
t-///s/7/1/
(//fl,Y/e 71v /t //
Contact person Phone*t%t?6,///rzaA
Please explairl any unusual or extenuating circumstances expected regarding the site assessment or closure:
I certiry under penalty ol law that I am the owner/ope I the tank(s) reterenced above and that I am familiar w,
the inlormation on this form and that it is true,and complete, and lurther, that the procedures describ
herein will be followed d
Slgnature ol tank owner
Full Name of tank owner
k closure.
oate r2-)/-AO
1 Soil (SS), Groundware. (GW). or Unified Soil Classilication (USC).
2 Approx. depth in leel below grade. The requrred minamum stte assessment samples musl be taken at 0-2 leet betow the backfilynalive soil interface.3 Conlaminanl compounds to be analyzed lor each sample (lrom table on p. 3).
4 App.opriate analysrs methods lor contaminant compound(s) in each sampte {lrom tabte on p. 3)-
Substance
stored in
tank
Sample
type'
ryflr,ffi*,,,
I
/1
*t
^
Closure Plan Review Summary
Facility lD 1000171
Number of regulated tanks at this site not previously closed: Database:
Certificate of Compliance lssued: Yes
TANKS TO BE CLOSED
Non-Notifier:
6 Closure Plan:
NO
6
Tank# Type Date lnstalled Capacity Substance Last Used Rmvd/ln Place
I
2
3
4
5
6
Impressed Current Cathodic
Impressed Cunent Cathodic
Impressed Current Cathodic
Impressed Cunent Cathodic
Impressed Current Cathodic
Impressed Cunent Cathodic
4130n985
4t30t1985
4t30n98s
4t30n985
4t30t1985
4/30n985
10000
r0000
10000
10000
4000
2000
Gasoline
Gasoline
Gasoline
Diesel
Gasoline
Kerosene
IN USE
IN USE
IN USE
IN USE
IN USE
IN USE
REMOVED
REMOVED
REMOVED
REMOVED
REMOVED
REMOVED
TANK REMOVER
Name STEVEN LYONS Cert. #: TR-TR-153 Exp. Date:
SOIUGROUNDWATER SAMPLER
Name: STEVEN LYONS Cert. #: GSG$]559_ Exp. Datet 10lU20|diu_
lf different from database:
Tank Owner: Phone:
Address: City: State: ZiP:
Site Name. Phone:
Address: City: State: ZiP:
Remarks:
Original CP to LHD; Copy to G.H.; Copy Cover Letter to file; Entered D.8.U25100; ARE ALL
6 OF THESE TO BE PULLED? VERIFY ON CP.
Friday, February 25,2OOO Page 1 of I
Ioobi]
ACCURACY TANK TESTING
1769 COUNTRYSIDE LANE . HEBEB CITY. UT E4C32 . 654.N37
Apri1 16, l-998
Maetex Supply Company
Steve Thomas
700 South University Ave
Provo, Ut 84603
Dear Steve,fhe underground storage tanks located at Maetex Suppl/
Company, 700 South Universj-ty Ave, Provo, Ut, were precision
tightness tested April 14, L998. The tanks were fu1I systems
tested with the USTest 2000 System using 2 psi of nitrogen for
t,he ullage test and a three hour volummetric underfil-I test.
Test results are enclosed and show the tanks to be tight.
The pressurized fuel lines were hydrostatic tested at 50psi for 30 mi-nutes. Test results show that the Ij-nes are tlght.
The fuel line leak detectors were tested to see if they
would detect a leak of at least three gallons per hour. All leak
deLectors funetion properly.
Thank yotr, and if you have any questions or need anyassistance, please caIl, 435-654-2737.
Sincerel Y,
I
Ned lioldaway
Accuracy f ting, Inc.
'!
Sttr
Addrcss
Lcrr Detertoc **o C//)
operattng pressure 2 /
Lea! Rate uaoca 3 ()/tL
Pressrre vt& Leek fu|r)Pass/Fail lfa < c
If falled was
Leali Detecror
Replaced Y[{
N'ew ['1q6 ei
Serlal Nuaber
ACCURACY TANK TESTNG
LNX TESTS
4 f,1
SD
70
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LEAT DETECTOR TESTS
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MIou trs Tested
Start
Eod
Chaogeful
Leak Rat{gph
Pess/fail
uru /',//'7
. MONTHLY FUEL REPORT
/a- zf z
Date Stan Stick
lnventory
Gallons
Pumped
Totaluer
Gallons
Delivered
Book
lnventory
End Stick
lnventory Draly Over or
(Short)
*2,
lnsnes Water lnitrals
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SUM GALLONSLeakCheck: ( ZjFcl'
PUMPED
) X o.ol + 130 z3>
; _ MoNrH/yEAR :fr"- ?7
Facility Loation:)- Lz- 4zr, ffi6s7. /2.,? t
Typeof Fuel.. /,?L personCompleting r"^l W
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Facility Location St--,1oo
Type ol Fuel'. Saza> Zrza
SUM GALLONS PUMPED
Leak Check: ( /11 3 ',-.' ) X 0.01
Date Start Stick
lnventory
Gallons
Pumped
Totalizer
Gallons
Delivered
Book
lnvenlory
End Slici(
lnventory
Dialy Over or
(Short)lhches Water lnitials
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+ 130 /?/
MONTHLY FUEL REPORT
MONTH/YEAR .2,6 €Z ,
Facility Registration Number. ,.,p/ 7 /
PersonCompletingFofin: Srtv.; 2r..4j
7zz\
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Facility
Type or ru.r, Zro, ,?,o,
MONTHLY FUEL REPORT
q2
Facility Registration Number: /.fr / 7 /
Person Completing Form:
- MONTH /YEAR
Loeation)o 4-. 4t
Date Stafi Slick
lnventory
Gallons
Pumped
Totalrzer
Gallons
Delivered
Book
lnventory
End Stick
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Dialy
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SUM GALLONS PUMPEDLeakcheck: ( /Z// ) x o.O1 + 130 /uj
Qae>s
lnitials
>".-\
/Z?/
MONTH / YEAR :
Su **.-- /:.r'
MONTHLY FUEL REPORT
-.-lb"d f7
Facility Registration Number:Facility Location:>/
fype ot Fuel: I S AJ2-- Person Completing Form: 57za' 7:'t"**s
X 0.01 + 130
Date Start Stick
lnventory
Gallons
Pumped
Totalizer
Gallons
DeliverBd
Book
lnventory
End Sticl
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Dialy Over or
(Sho.t)lnches Wate.lnitials
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Facility Location -..1- i--'- ,fi2
MONTHLY FUEL REPOR]
MONTH / YEAR . /'/'/r4; 7 ./
Type ot Fuel /-/22
Date Start Sticl
lnventory
Gallons
Pumped
Totalizer
Gallons
Delivered
Book
lnventory
Dialy
(S
End Sticl
lnventory
Over or
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cc',/' , 2 /27 tat)_ t5
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SUM GALLONS PUMPEDLeakcheck: ( 3: '- )
Facility Registration Nwnber. /,2./7 ./
Person CompletingForm: 9/d;s 72.:tt s
-t3 ,
1,
,;=
Facility Location
Type of Fuel 41>-a.
MONTH /YEAR :
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MONTHLY FUEL REPORT
?=
Facility Registratio n Number: -t2 z " '
Person CompletingForm. i,y': -; '1 *r ''
Date Start Strck
lnventory
Gallons
Pumped
Totalizer
Gallons
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lnventory
Dialy Over or
(Short)lnches Water lnitials
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) x 0.01 + 130Leak Check: ( 7 --)/2FSUM GALLONS PUMPED
I
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I II
DEPARTMENT OF ENVIRONMENTAL QUALITY
DTVISION OF ENVIRONMENTAL RESPONSE AND REMEDIATION
168 Nonh 1950 West
P.O. Box lzl4840
Salt I.ake City, Utah 841l4-4840
(801) 5364100 Voice
[phone] Fax
(801) 5364414 T.D.D.
March 26,1998
Matex Supply
700 S. University Ave.
Provo, UT 84601
Attn: Stever Thomas
Underground Storage Tank Section
Janet J. Keller
Envircnmental Scientist
loc,drl (
Michael O. Lravitt
Govemor
Dianne R. Nielson, Ph.D
Execu!ive Director
Kent P. Gray
Director
TO:
RE: Non-compliance of underground storage tanks at each facitlity as indicated:
To continue to maintain a valid Certificate of Compiiance, this facility must be in compliance with
Federal and State Rules and Regulations. Compliance reviews, performed on 12104197, indicate you
have not satisfied the requirements of the Act and are out of compliance. To achieve compliance you
must do the following:
Facility 1000344, 109 E Main, American Fork:
l. Submit a copy of a current precision tank tightness test for tank(s) # 1.2.3 .
2. Submit documentation to show that you have had a qualified cathodic protection tester
test your cathodic protection system within the last three years.
Facility #1000171,700 S. University Ave, Provo:
1. Submit a copy of a current precision line tightness test for the product lines associated
with tank(s) # 1.2.3.4.5.6 .
2. Submit a copy of a current annual test for proper operation of the automatic line leak
detectors on the pressurized product lines associated with tank(s) # | . 2. 3 . 4. 5 . 6 .
3. Submit evidence that proper Inventory Control is performed on UST(s)#by:
a. Documenting that inventory records are reconciled monthly to determine the total
overage or shortage for each UST, and the variance is compared to the allowable of
130 gallons plus one percent of the UST's monthly throughput.
Facility # 1000497,3179 N. Conyon Road, Provo:
1. Submit documentation to show that you have had a qualified cathodic protection tester test your
cathodic protection system within the last three years.
2. Submit evidence that proper Inventory Control is performed on UST(s) # 1. 2 by:
v
Page 2
Documenting that inventory records are reconciled monthly to determine the total overage
or shortage for each UST, and the variance is compared to the allowable of 130 gallons plus
one percent of the UST's monthly throughput.
Facility # 1000399,690 W. State, Pleasant Grove:
1. Submit documentation verifying the installation of overfill and"/or spill prevention on tanks #-l
2.3.4
2. Submit documentation verifying the product lines associated with tanks # 1. 2. 3. 4 a^re
cathodically Protected.
Facility # 1000164, 1316 S. University Ave, Provo:
1. Submit a copy of a current precision line tightness test for the product lines associated with
tank(s) # 1.2.3 .
2. Submit a copy of a current annual test for proper operation of the automatic line leak detectors
on the pressurized product lines associated with tanks # 1. 2. 3.
Facility #1000259, 1601 W. Center Street, Provo:
1. Submit a copy of a current precision line tightness test for the product lines associated with
tank(s) # 1.2.3 .
2. Submit a copy of a current annual test for proper operation of the automatic line leak detectors
on the pressurized product lines associated with tanks # 1.2. 3.
The above information must be submitted to this office by 05/30/98. If it is not received by the date
specified, we will corlmence the revocation process of your Certificate of Compliance.
If you have questions concerning this matter or need any assistance, please contact Janet Keller at
(801) s36-4121.
Ownor N!m6 -.>L$L
Addr666
zip Codc
Ares Codo Phono Numbor
Phono ,
6f trnk. ,t fr.ilitv:
St.t6City
ln
3 \,le
Contsct Porson At UST Locstion
countv L[rA H
A ff-
City a
A4
St.to, ,-_ ZiD Cod.w I '#bo\
g
F.cility N.m6
Stroot AddreBs
Cortiliclto of Complilnco on dto?. Yor
-l Expirltion d!t6:
7oo 3. t
utrtx
Trnl li.rid 6n C.rrificrre (lf Comblirnc.Yer Na Yai -a---->N6
Tenk or6B6nllv in uB6
ll n6t in rl^.- .lit6 lert rm.d
l, noi in uEe. d.olh of ordducr in lrnk tin inche^l
Month and v6er tenk in6tell6d iqES -C.o.citv of t.nk lin o.llon6l l0l<3E )K
Substenca stor6d ?rz,n dn Ttns f'ret I Hi kroq
Mrtarirl d, .(thstfllcti.|n 6f 1r^l lrr..l FRP .r. I 5t,? s *
Mrteriel of conllruction of rlirlind l.t.el. FRP. et. l FR? ---?
E
lnventorv Control/Tenk Tiohtn.ss Tesrino
Automatic Tank Gauoino
M6nual Tenk Gauoino
VaDor Monitorino I
Groundwater Monitorinq
lntorstitial Monitorino I
Statistical lnvonioru R6concilierion lSlFl
Lin6 Tiohtn€ss T6stino
Vaoor Monitorino
Groundwat6r Monitodnq
lnt6rstitiel XioDitorinq
Stetisticel lnventoru -Eaconciliation {SlBl
Comments
c€rti thst havo ath6 bovo-nam lacid lity
lnspoctor's Signsture
Signature ol Own6r or Owner's Rspressntativg Presont During I
EE Elf,FzlGF]i''/a,*,R=
-I
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-
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Distribution: Whit6-DERR, Y nspoctor, Pink-Fscility/Owner
:iiiiilirllillitliir
iiiiiiii;iii.iii.iii.iii:;.i:;'ir}iillil l*iti.[flifSffi{fjiiili,iir,iiiii;ii ffitlI#"iffi
Ffiardan.v Ga^ar.t6r tr^k ll.,L .l.t..ri^^ ,l.t.r..rll
Oihdmn6r.ve.l m.rhn.i rin.li.era ^.ma ^f m.rh^.ll D DELIVERED
Armmrii. I ina I arl D.i..r6r y' .--
Tank 1 ^Tank 2 '\ Tat
{lo---+r#-+e#{o-
The UST system is filled by translors ol 25 gallons or less. lf yes, spill
and overfill prevention is not required.Y"" (N"/
Yes No Yes No fdrls lhere a spill containment buckel or anolher device that will prevent
release of product into the environment?>c
Yes No Yesls there an overfill prevention device installed on the tank? lf yes, indicate
th€ type of device: Ball float (in vent line), Automatic shutoff (in fill pipe),
Alarm, or Other (specify)
YeS No
/q3
Yes No No
For overllll alarm only: ls the alarm located where lt can be easily seen
and heard by the delivery driver?Yes No Yes No Yes No Yes No
For overflll alarm 6nly: ls the alarm clearly marked to indlcate what ls
meant when tho alarm sounds?
Tank I
Yes No
Tank 2
Yes No Yes
Td
No Yes
Tar
No
-t:
rk4
Tek ffk T-a *_>
I PiPphsFP*
SuEPurp:+-c
hDismo.rn$t
lndicate the type of corrosion protection on Flex conneclors and/or Swing
joints: Booted (B), Total containment OC), Not in contact with soil or water
(NC), Cathodically protected (CP), Non-metallic (NM) and Not Protected
(NP)
OiM&rTC
Yes rtnk No Yes r"nk No Yes T.nk NO Yes .nk NOll the UST is not protected, was lhe tanUpiplng lnstalled before May 7,
1985? It yes, corroslon protgcton is not requlred untll D,ec. 22, 1998;
do not complete the remalnder ol thls sectlon.Yes P'Pnc No Yes Pipne No Yes Pidng NO Yes r tsne No
The results of the last two cathodic proteclion tests are available. (within
6 months of installation and every 3 years thereatter).Yes No Yes No Yei No Yes No
- i.1 I vorts -1.80 ,6,tkff
-),O,
ffi+volts-2.12
i ( volts \ r volts l(volts a (tt voltsl/
Results of the most recent cathodic protection test.
Tank
Piping
Flex
Test f\ala.
Name of
'' 2 ,Quotr".- T.Ovotts -2.0 ^zws -w -Zrb
For lmpressed current system: The results ol the last three equipment
operation checks are available. (Equip. check required every 60 days.)No(G)Yes No rs NO rel -+
lf the tank has been retrofit (lined or cathodically protected), indicate the
date the relrofit was completod.
IZlnspector's Signature q
Facility meets 1998 upgrade requirements.
t,
G,rint natu)
understand that the following marked items must be completed by
Signature of Owner or Owne/s Representativs Presgnt During
D Corrosion prolection for pipingrfex assoc. with tank(s) #
December 22, 1998 in order to meet the 1998 upgrade requirements:
tr Corrosion protection for tank(s)
tr Spill prevention ,or tank(s)# ,
D Overfill prevention for lank(s)#_
Olslribulion: White-DERR,Pink-Facility/Omer Revissd 0U0&97
UTAH UST PROGRAM
and Gorrosion
Facility lD No. i el rlil i T /
Ghecklist
Pleasc corplete all lnlorrffin lor edr tank Usc addlttonal lorme E n€eassary It tho faclUty haa moro thon 4 tank8.
tteP4 z:'fat wL.
COAROSI.9N PBOTECTION
hk3
Indicate the type of corroslon protection: Non-metalllc (NM), Composite
steel (CS), lntemal lining (lL), lmpressed Cunent (lC), Sacrificial Anode
(SA), or Not protected (NP).
Dis
- l, $lvorts
I
Frala.
This method of leak detection requires both monthly inventory control reconciliation and tank tightness testing. lf the UST has not been upgraded
(upgraded means that the tank and piping are protected from corrosion and that spill and overfill prevention devices have been installed) the tank
needs to be tightness tested annually. lf the UST is upgraded the tank needs to be tested every five years. lnventory records must be kept for
each operating day.
{r") No No6A GS YluoRecord of last Tank Tightness Test available on-site
iTaJqu -Date of last Tank Tightness Test
Fail Fail F)'Result of last Tank Tightness Test. lf fail, specify in comments section what
actions have been taken to correct the problem. Has DERR been notified?@1 I6\
Type / Brand of test equipment used:
I
Name and company of tank tightness ,""tur, ,frC CWf&fl4J\g\4lCl}O Utah Tester Certificatior 1 Number: UT ot11
Documentation of performance claims for the Tank Tightness Test method is available
0.1 gph with 95% or greater probability of detection and 5% or less probability of false alarm (3rd party certification)
lnventory volume measurements for regulated substance inputs, withdrawals,
and the amount still remaining in the tank are recorded each operating day
YesesNoYes No
shows the ability to detect lea sof
ll*:::lt:::::::::: :i:l:
No
Gr
H
No
No
Yes No Yes Nolnventory is reconciled monthly (sum of daily over and short for each month
is compared lo 1o/o oI tank's flow through volume + 130 gallons)
Yes No Yes No
Which months exceed the allowable over-short? (specify month and year)
Yes No Yes Nolnventory Control records are maintained and available for the past 1 2
months for each tank
Yes No Yes No
-Yty---lttf---+es ---Ne---Ysi6*-l.*--Records include monthly water monitoring to the nearest 1/8", --il6
No<"")Yes No Yes NoMonthly water readings are used to adjust monthly inventory balances I No
Yes No Yeq NoAppropriate calibration chart is used for converting product level
measurement to gallons and is available for review
No No
NoYcs--Ns--Dispenser pump has a current calibration sticker or appropriate
documentation
No "tg
Nt^tube is present and it extends to within one foot of tank bottom
Owner/operator can explain inventory control methods and demonstrate acceptable gauging techniques No
The volume of product in the tank is measured using a:<.Stick 5 ATG
-lfa gauge stick is used, it is long enough to reach the boftom of the tank No
lf a gauge stick is used, the bottem of the gauge stick is:Worn
lf a gauge stick is used, it is marked legibly and the product level can be determined to the nearest 1/8 of an
inch over the full range of the tank's internal height
No
Comments:
q
Signature of Owner or Owner's Representative Present During
lnspector's Signature
II
Distribution: White-DERR,Pink-FacilityiOwner
G
@,
Ye9
vo" hT g5 tlu
Trtk I Trif 2Set I .-\5Tx r+ ld
Q"l)a-cl,e{.oAutomatic Flow R€slticto, {if yos, indicrte modgl in comments 66ctionl -)
l
Automstic Shut-off Oovico {it y65, indicrto modol in commonts soaionl )
Continuou6 Alarm Systom (if yes, indicoto modal in commonts 3ection)
Y66 lHoRocords ot la6t Lin6 Leak Dotoctor porfo.manc€ iggt aro avEilabl6 on_sito
4itoht"-:>Dsto ol last Lin6 Loak Dolector psdorm.nc6 t6at
F!ila6a FsillA)/e'aaa)?ol 't Pr"*FsilRssult ot la6t Lino Lo.k Dot6ctor p€rtormlnco toat
Sot 2
Y 66
-t\R
-NO ro6 -+Socords ol la6t Line Tightnoss Tost sro av6il6bls on-aito
bl)olgb'--;> I
IDrto of l6st Lino Tightnoss Tost
I Fail ,R) r.u /eicd)Prsir (G |) F.irR6.ult ot last Lino Tightno8s Test
lion Numbor: UT a i4'tNamg and company of c.niri6d toEtor:/* a-gacaua . NaA HoAapl-,1u,"nt"",", Jn,,,".-)
Vapor Monitoring {if yos, u8. Vapor Monitori ch6cklisll
In
Groundwator Monitoring (if y65. uEo Groundw.to, MQnitoring checklistl
lntorstitial Monitoring (if y€s, usa lhter8tilial Monitoring ch€ckli$t)
Statistical lnventory Reconcili.tion tSlRl (it yos, us6 SIR chocklistl
I::!:!:!l::m
.Xilliiiiilli,ri,ii,i.ltii.i.ii
Y6B No [E M V:E
method (if y6s, u6E othor mothod checklist)
Rocords of l8st Lino Tightn€65 Tesl ar6 availablo on-6ite
Othsr a
Ye6 No
4t'/,, uDato ot lsst Line Tightnoss Tost
Pass Fail Pass Fail Pa65 Fsil Pass ,J.,!)lR€sult ot la6t Lin€ Tightness Tost
Vapor Monitoring {if y6s, uso Vapor Monitoring checklist)
Groundwator Monitoring (if yos, use Groundw.t6t Monitoring checklistl
lnterstitial Monitoring (if y€s, uso lnterstitial Moniloring ch€cklist)
Statistical lnvontory Reconciliation tSlRl (it yos, use SIR checklist)
YoE No lEE VE
method (if yos, u8o bthor mothod checklist)
Operltos at l6ss than atmosphotic proa6uro
Othor
Y€s No Ntt Nlt
Yos NoYes No Y6s No YeG NoSlopo of piping will allow ALL product to drain into tank wh€n 6uction i$
rcloai6d
Yss No Yoa No Yes No Y€6 NoHa6 only ONE chock valve, locatod dir6ctlv undor pump
Yos No Yes No NoAll abovo info.mation on suction piping is VERIFIABLE, us€ commonts
ssction bslow to documont how it is vo.ifiable.
I
Dato
Comments
signaturo of Owngr or Ownor'6 Represontative Prosont Dur
lnspsctor's Signature
IIIE IIIII
-
I-
---
-II
I
II
I IIIIIITIIIIIIIIIIIIffiffiElilE5ilII
rITIrITIrITIrIIIIIIIffircEEEE
Distribution; Whit6-DEBR, Y€llow-lnsp€cto., Pink-Fecility/Owmr
St.t6 ziD cod6vff E4 tooz
Are! Codo Phonq Numbor
Phonc #
Nrmher df t.nks rt fecilitv:b
4
Aue
"* ?u^ovo
Contlct Porson At UST Localion
Addr633
"700 3 Llvrt v
Zip Cod.
/.IAA
St.to
n-.4-
Conificrt6 ol Complilnco on !it6
County
Facility Namo
St 66t Addre66
cttv (r- Jarnal
T.nk listed on C6rtificel6 of Comolience
,.\ \2n"
T.nk Dr.sentlv in us6
ll mr in ur.- .lrt h.t rE.d I
lf n6l In use. deoth of Drdducr in irnk lin incharl
Month end v€ar tank inBtallod _>
CeDrcilv ol renk lin oellonsl -*lbK 3K JK
SutrsteacD stored I Wrrtt,r [,Ln ' (arron14aD,cil f-i..u
Materiel of conBtruclion of tenk Isto6l. FRP- erc-l )--->
Metoriel of construction of oioino lst66l- FRP. etc.l rRP
-rr!_--_-::!r:*l-r
8ffii :c
FTE
ii*dllEfi
a.
lnventoru Control/Tenk Tiohtness T.stino
Automatic Trnk Gsuoino I
Manual Tank Gauoino I
VrD.'t Monirorind
Groundwator Monitorino
lnlerstitiel Monhorino
Statistical lnventorv Roconcilietion lSlR)
i#ffii*iiiiil:i il
:::i: !::lii:;:i::
iaitiridi
Line Tiohtnoss Tesrino I /
Vaoor Monitorino
Groundwater Monitorino
lnterstitial M6nitorino
Statistical lnv6ntorv Reconciliation lSlRl
Other eDorovad method lindicrte name oI m.rh6.il
th6 abovo-nsmod facility onr-corrify
s K
q
n
Commonts:9
t.
lnspector's Signaturo
Signaturo of Ownor or Own6r's Representativ€ Prssent Duaing lns
Oistribution: Whit€-OEnR,Yellow-ln!p.ctor, Pink-Faciiity/Own6r
s
owni N'mo rvrat fuqer4qn
d!t6:
l-!=-
\
This method of leak detection requires both monthly inventory control reconciliation and tank tightness testing. lf the UST has not been upgraded
(upgraded means that the tank and piping are protected from corrosion and that spill and overfill prevention devices have been installedl the tank
needs to be tightness tested annually. lf the UST is upgraded the tank needs to be tested every five years. lnventory records must be kept for
each operating day.
68----Yes NO e5 ITO YesRecord of last Tank Tightness Test available on-site
.\
Nd
zl-aoh*--7Date of last Tank Tightness Test
FailPass PassPass FailResult of last Tank Tightness Test. lf fail, specify in comments section what
actions have been taken to correct the problem. Has DEFR been notified?
ra(
-7
Type / Brand of test equipment used:
Number: UT f,Name and company of tank tightness tester:w Tester l1-7
of
-
fi',i8,,,.,:i,,::::,,
No
,o
,l::::::::l ial
Yes
Documentation of performance claims for the Tank Tightness Test method is
0.1 gph with 95% or greater probability of detection and 5% or less probability of false alarm (3rd party certificationl
lnventory volume measurements for regulated substance inputs. withdrawals,
and the amount still remaining in the tank are recorded each operating day
YesYesNoYes No
and shows the ability to detect lea No
No
YesYes No Yes No )Nlnventory is reconciled monthly (sum of daily over and short for each month
is compared to 1o/o ol tank's flow through volume + 130 gallons)
tlto ^'lc zllb 0l* ohWhich months exceed the allowable over-short? (specify month and year)
Yes YesYes No No
lt
No7lnventory Control records are maintained and available for the past 12
months for each tank
Yes No Yes No Yes
:d
Records include monthly water monitoring to the nearest 1/8'
res-rIr g5 NO Y es--#Monthly water readings are used to adjust monthly inventory balances
YesNoYesYes No
'J"
Appropriate calibration chart is used for converting product level
measurement to gallons and is available for review b
Yes No Yes No Yesfr.U No No
->
/ Dispenser pump has a current calibration sticker or appropriate
-documentation
No
- rvPdrop tube is present and it extends to within one foot of tank bottom
Owner/operator can explain inventory control methods and demonstrate acceptable gauging techniques
No
Ah" uolu^.of product in the tank is measured using a:I '6i6.3ti"D ATG
lf a gauge stick is us€d, it is long enough to reach the bottom of the tank es No
lf a gauge stick is used, the bottem of the gauge stick is:Worn
lf a gauge stick is used, it is marked legibly and the product level can be determined to the nearest 1/8 of an
inch over the lull range of the tank's internal height
No
Comments
Signature of Owner or Owner's Representativo Present During
lnspector's S
1
Distribution: White-DERR,lnspector, Pink-Facility/Owner
Fail
\-<<--.-
No
Tank I Tank 2 l :.'lufi4 f r^,'r* le
Yes No Yes No Yes/tn" USt system is filled by transrers of 25 gallons or less. lf yes, spill
and overfill prevention is not required.
Yes ,6")t/-No+
NoYes No Yes YesrGD No/ls there a spill containment bucket or another device that will prevent
-ielease of product into the environment?
I ttol-:2
NofYa Nou*^.fr*No
vafu,t
Yes
*ul
Yes
,o
ls there an overfill prevention device installed on the tank? lf yes,
indicats the type of device: Ball lloat (in vent line), Automatic shutofl
fin titl pipe1, Alarm, or Other (specity)
Yes No2
Yes No NoYes Yes NoFor overlill alarm only: ls the alarm located where it can be easily
seen and heard by the delivery driver?
Yes No
Tank I
Yes No
Tank2
Yes No Yes
:: :: : : . ::::.1
I et
For overfill alarm only: ls the alarm cleady marked to indicate what is
meant when the alarm sounds?
k3
No Yes
Tt nk4
No
Tmk 1 nkTankTC-Tmk >
reTC-Llm
lndicate the type of conosion protection: Noncorrodible material (FRP),
Composite steel (CS), lnternal lining (lL), lmpressed Current (lC),
Sacrificial Anode (SA), or Not protectod (NP). lf FRP or CS do not
complete the remalnder ol this section.=>
Yes No
lf the UST is not protected, was the tanUline installed before May 7,
1985? It yes, corrosion protection is not required until Dec. 22,
1998; do not complete the remainder of this section.
Yes No Yes No Yes No
The results of the last two cathodic protection tests are available
(within 6 months of installation and every 3 years thereafter).
No@ Yes No Yes No Yes No
-1,86 'oo'
Tank
*1,71
Tail
volts
T
qt*1,
{l,q+
volts-.U It*,1
Um
)zW,
Results of the most recant cathodic protection test.
Vl a.,,-= Scrhrrro bL+
Test I
Name of
volts
Llrp
N,lA 4p- o- "ffPd y',T
Llm
Tvorts4r-7'l.
For impressed current system: The results of the last three
equipmsnt operation checks are available. (Equjp. check required every
6o days.) Ai.sl a"L\tcl t@ D lqj
No Yes No Yes No Yes No
December22,1998inordertomeetthe1998upgraderoquiremenls:!Spillpreventionfortank(s)#,
,-1/L/lnspector's Signatu Date
Signature of Owner or Owner's Representative Present During
understand that the lollowing marked it€ms must be completed by
(pdd lme)
E Overfill prevention for D Corrosion protection tor tank(s)
I Corrosion protection lor piping assoc. with tank(s)msets 1998 upgrade requirements
lf the tank has been retrofit (lined or cathodically protected), indicate
the date the retrofit was completed.
Distribution: White-DERR, Yellow-lnspector, Pink-Facility/Owner
UfAH,U$T,
and ,Oor.o$.iori.
lormE as has,,rnore lhan 4 i:,.....
SPILUOVERHII PnEVHt{,fi OH
Ftease Ell,lrdor,rr,Ictbn::laii€'H0' ,,iar*. Usb
6o,n n0B|dllilPn0 Efi ioillii
UPGRADE NOTIFICATION
Tx* ISet 1 T.r* 2 7: rt tF+fr.Lfu
%1q4*'autAutom.tic Flow Rosticto. {if yo6, indic.to mod6l in commonta aoction}-->ruA
Automatic Shut-qf, Orvico {it yos, indicEto modol in commsr s aoction} )
Continuous Alarm Systom lif y6s, indicslo modol in commonta soctionl
o8 -Yes No Yos NoR6codB of la€t Lin6 L6.k Dotoctor porformcnco test aro av.ilable on-lito
--5
-l6a No
)6Dato of lasl Lin6 L6ak D6t6ctor pg.formanco t66t -=>
Result of last Lino L6.k D6toctor psrformanco tost P6!a Fail Pass Fsil /Paat
Set 2
Y6s -roRocord6 of la6t Line Tightn6s6 Test rrs avaihblo on-6itg )r."No?Dat6 of last Lin6 Tightnoss To6t
Pass Fril-Pass F.il ,'' PaztRe.ult ot lart Lino Tightnoss Tsst Fail
ltion Numbo,: I r o t1'7Nlmo and company of conifisd tostlr: Nd frOth,Uhllt h c c u d{ y -1 a nV'ffiA,f,
"stor crnrrk
V.por Monitoring (it yos, u6o V.por Monitoring ch6cklist))
Groundwator Monitoring (iI y6s, uso Groundwat6r Monitoring ch6cklist)
lntorotitial Monitoring (i, yos, us6 lnterstitial Monitoring chocklist)
Statistic8l lnvontory R6conciliation [SlR] {it y6s, us6 SIR chocklistl
YoB No Y68 No M M:E
mothod (if y6s, use othgr msthod chocklist)
Rocords of last Line Tightnoss T66t 8ro availsblo on-sito
Othor a
tiair,!
Date of last Lino Tightness Tost aiah
Pass Fail Pess Feil PassRosult of last Lin6 Tightnos6 Tost Fail Pasr
_z\eall .
Vapor Monitoring (if yas, us6 Vapor Monitoring chocklistl
G,oundwatff Monitoring (if yos, uso Groundwater Monitor checklist)
lntorstitial Monitoring (il yos, us€ lnterstitial Monitoring chocklist)
I
Statistic.l lnvontory Reconciliation IS|Sl (if y6s, u6e SIR checklistl
mothod (it y6s. uso oth6r m€thod ch.cklistl
Oporstos at lo6s than atmosph6ric pr6ssur6
Othor
Y6s No Y66 No Ye8 No Y66 No
Slop6 of pipino will allow ALL product to drain into tank wh6n suclion is
16loa6od
Ys6 No Yos No Yss No
Ha6 only o E ch6ck valve. located diractly undsr pump Ye6 No Yes No Y6s No Yos No
All above information on suction piping is VEBIFIABLE, us6 comm€nts
section bslow to documont how it is veaitiablo.
Yas No Ye6 No Yos No
Commgnts
Signaturo of Own€r or Owner's Rsprosonlativo P.ssant Ouring
lnspoctor's Signature:
rIIT
IIII
EEGX')
rIIIrIII
II
--
IIII
I
EWm
II
-I
II
II
II
ffiffi
IIII
IITIIIII
II
Obtribution: Whit6-DEBR, Y , Pink-Facility/Own6r
I *; t,,,x_n^'*:,-..T:4,-:t.stlii:l
Fail
Yeg No
Facllity lDNo. lOoOl'1 (
NOBTH
,"R o$"e<,
*$a$&'f&""*4
o
c btAk
*'6..r tISPw;rn
x
X i/,^.l, Vdk-at*ulo'o oep^ilbum*s
the location o, any reported PID or Flo readings-
o
x
Uo
x
o
Polential Receptors- lndicate distance (in feet) to the nearest: Residences _ Buildings _ Buried utilities
Comments
Active waler well Other
tVta,,^.- W certily thal I in
lnspecto/s Signatu Cert* fT-o0% oate
d the above-named facility on
FACILITY SITE PLAT
O
Surface water _
l0oo/)/State of lltah
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF ENVIRONMENTAL RESPONSE AND REMEDIATION
Michael O. Leavitt
Governor
Dianne R. Nielson. Ph.D.
Exrcutive Director
Kent P. Gray
Diretor
168 North 1950 West lst Floor
Salt lake City, Utah 84116
[phone]
[phone] Fax
(801) 536-.1414 T.D.D.
1
January 4,1995
Wfr
-o)
\(TO
RE: Non-compliance of underground storage tanks at Maetex Supply, 700 South University Ave., Provo, Utah;
Facility I.D. #1000171
The Utah Underground Storage Tank (UST) Act provides that the Executive Secretary (UST) may revoke a
Certificate of Compliance if it is determined that a facility is not in substantial compliance with all state and
federal UST statutes, rules and regulations.
At the request of the Executive Secretary (UST), the Division of Environmental Response and Remediation
(DERR) performed a compliance review for the underground storage tanks at the above facility. The compliance
review, performed on October 19,1994, indicates you have not satisfied the requirements of the Act and are out
of compliance. To achieve compliance you must do the following:
L submit evidence that proper Inventory Control is performed on USTs #7,#2,#3,#4, #5, and #6 by:
Documenting that the liquid volume in each UST is measured, each operating day, to within one-
eighth inch, including measurement before and after each delivery, and reconciled to daily
withdrawals.
The above information must be submitted to this office by 02-03-95. If it is not received by the date specified,
we will commence the revocation process of your Certificate of Compliance. If you have questions concerning
this matter or need any assistance, please contact Therron Blatter at [phone].
Maetex Supply, fnc.
At.t.n: Steve Thomas
700 South University Ave
Provo, Utah 84601
a
0l/04/95 8:(Xm
Printed on recycled paper
2 34 E
tJ
(^)
.A
a.fr **tex Supply Companj, Ine.
FOOD MARTS _ TEXACO PRODUCTS - GAS CARD
7M SOUTH UNIVERSITY AVENUE
Phone [phone]
PROVO. UTAH 84601
f:e bt'r-rai'y e! 1995
TO:
Remediation
Uni.veI.Eity flvenueitti r ivlaet ex Sr-rppl y Company,
i:'r.o v o, Utah
Faci 1it y LD, #lraqB171
inc., TEttZt So r.rt n
I irave been doing weekly .:ttck and metei. I.eadlngs tfir.oLrgi-l
Decembe!' 1.994. Star.ted doinEl daily stiek/meter r.eadings Januar.y
1995 on all 1O, OrarA gallon tanks (Supet" lJnleaded, Unleaded,
Un L eaded F,Ius, and Diesel).
Depai'tment of Envir.omentai Gr-tal ity
Division of Envil.onmental Response
Lln e, UAO gal lon and J, latala gaI lon tanks I am
t'eadings hreekly. I waE told that I ciidn't
and i, OIZ|E gallon tanks 6ai1y.
Stephen Th omas
lvlaet ex Supply Company, Inc.
st i I i
need t o
do ing thE
do the f,EO|Z
4!
MONTHLY FUEL NEPONT
MONTHJYEAR :12 ar
Actttrv t-ocnttoH:
t't?E oF FVELT /-/Za-
;ACIIIlY BEGISTNAIIOT{ NUITEEF: /ADI ?,/
PEFSOT{ COMPLEIING FOHM:
loox
ltrvEHtonr
tHo S,|Cr
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olttY ov:i
on
<tHont>
fiotEt
wltEn
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oatlotls
0tuvEnEo lMtl^tt
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/ni-qr
|.t..?"c:{
it-/d;,
SUM OALI.O'{S PUMPED
.01 + 130 1--//
/s;y>l I zrrl -z<G€> I
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I ,77?+/€F .uo ,,7td
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MONTHLY FUEL NEPON'T
'ACILITY
REGIS TnAilOr{ NU|}iBEH: /mr 77
MONTHIYEAR :
fA TE
<. f-r'
/-i.#r
t '.{ta*
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suil oAttot{s PUMPED
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q/
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/ -ffiY MONTHLY FUEL REPORT
MONTH EAR "3/
:AcrlrrY LocaTto n, Zi aL hrl, 4ZZ
IYPE OF FUEL.
:ACILITY B€GISTRATION NUM
PERSO'T COMPLETING FORM:
8ER:
srltt
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GlttotS
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SUM GAI.LOIVS PUMPED
r /y'fZe x
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rF LEA( CHECX nESULT ts GnEATER IHAN SUM OF DAILY OVER OR < SHORT> . flOnFY REGUU\TOnY AGS'|CY
LEAK CHECX:
/424
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SUM OATLO'IS PUMPED
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LTAT CHECT:x
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olttolll
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MONTHLY FUEL REPORT
/MONTH q7
FACILITY REGISTnATION NUMBER: /'?Z/ 7 ,/ricrLtTY tocaTto :
IYPE OF FUEL:
fAIE
'/^/ -
PERSON COMPI.ETI G FORMI2.za
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EOOX
DryEllTORY
EllO SrCX
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oa
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,4tz
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. nctLtrY Lacaro't, 7D Jo lz,,/*:ACILITY REGISTRATION NUMEER:
rYPE OF FUEL:PERSON COMPLETING FONM:
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IF LEA( CI{ECX NESULT IS GNEATEN THAI{ sUM OF DAILY OVER OR <SHORT>, NOTIFY REGULATORY AGENCY
' Q '"'-o
o^,-.o*" I IPur.PEoloettoflslgoo.
rorrrlzrn I ottprnro I rrvErroRy
rEcx
,77a-)\-=-
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a
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o
la
ae I
.T\
Michael O. Lravitt
Governor
Dianne R. Nielson, Ph.D.
Extrutive Dircctor
Kent P. Gray
Diretu
DEPARTMENT OF ENVIRONMENTAL QUALITY
DryISION OF ENVIRONMENTAL RESPONSE AND REMEDIATION
168 North 1950 West lst Floor
Salt Lake Ciry, Urah 84116
[phone]
[phone] Fax
[phone] T.D.D.
January 4,1995
TO:Maetex Supply, fnc.Attn: Steve Thomas
700 South University Ave
Provo, Utah 84501
RE: Non-compliance of underground storage tanks at Maetex Supply, 700 South University Ave., Provo, Utah;
Facility LD. #1000171
The Utah Underground Storage Tank (UST) Act provides that the Executive Secretary ruSD may revoke a
Certificate of Compliance if it is determined that a facility is not in substantial compliance with all state and
federal UST statutes, rules and regulations.
At the request of the Executive Secretary (UST), the Division of Environmental Response and Remediation
(DERR) performed a compliance review for the underground storage tanks at the above facility. The compliance
review, performed on October 19,1994, indicates you have not satisfied the requirements of the Act and are out
of compliance. To achieve compliance you must do the following:
l. Submit evidence that proper Inventory Control is performed on USTs #1,#2,#3,#4, #5, and #6by:
a. Documenting that the liquid volume in each UST is measured, each operating day, to within one-
eighth inch, including measurement before and after each delivery, and reconciled to daily
withdrawals.
The above information must be submitted to this office by 02-03-95. If it is not received by the date specified,
we will commence the revocation process of your Certificate of Compliance. If you have questions concerning
this matter or need any assistance, please contact Therron Blatter at [phone].
01to4/95 8:04am
Printed on recycled paper
* ttoale-x Su.ptl*Facility Name
TI
Zip Code
q;
J
StateCity
No Expiration
County
Certificate of Compliance on site?
LV
Phone Number
Zio CodeVlbn"a
Area Code
Phone #
Number ol tanks at facilitv:
o
t^<_A
City ?.*
b
T_
a.x
oo 3,Address
State
Contact Person At UST Location
Owner Name
RJ No ff*n,Ef*oTank listed on Certificate oJ Oompliance m No ffi No frea NoTank oresentlv in use
lf not in use. date last used
-L n8, -Month and vear tank installed
lo tLCaoacitv of tank (in qallons)
Jr,,fuaL 'I)."'.r,l1rr--rn.-I PL,t-r.-Substance stored *lPz-Material of construction of tank (steel, FRP. etc.)
iraterial of construction of oioino (steel. FRP. etc.)ffitEliiit*iilir:::: ibu
Emeroencv Generator tank (leak deteelion deferred)
lnventorv Control/Tank Tiohtness Testinq
Automatic Tank Gauqinq
Manual Tank Gauoino
lnterstitial Monitorino
Statistical lnventorv Reconciliation (SlR)
Line Tiohtness Testino
VaDor l\ronitorino
Groundwater Monitorino
lnterstitial Monitorino
ore)
certify that I have inspected the above-named facility onr/
L0lnspector's Sig
Signature of Owner or Owne/s Ropresentative Present
Distribution: White-DERR, Yellow-lnspector, Pink-Facility/Owner
58qx
,
. ...,. .. ., , ... ...,... .. .
'
i ti..l : t,::.,: ,: . ..
.,.iiiiUTffi ....U$lF i...pHgGHfiM.i..i ir....,.,,
: :::'r,.,. t a,l:7* r*l.lFacilitylDNo.JW
ll. L tl6n:r6fit,fank(*)l. Ownership of Tank(e)
Street Address
SIL/WLA
lNn
lf not in rrsc denth of oroduct in tank (in inches)
--_-t
EQP
-
-
2Pioino tvoe (oressure. suction,oravifu etc.)
,-
\/annr h,lonitnrinn
Gror rndwater fu|onitorino
f)thar annrdved method [indicata name of method\
t/ --Aulrlmatic I ina Leak Detector
Statictinal lnventnru Flaeonciliatinn /SlFll
Olhar annroved method (indicata name of method)
I
Facility Name
Street Address
Zip Code
ZrrLl*-
StateCity
No Expiration dat)a^eT
County
Certificate of Compliance on site?
-r Stats Zio CodeVro,to. tr 294-O<
PhonENumS;Area Code
Phone #Contact Person At UST Location
Number of tanks at lacilitv:(/
City
1 A
Owner Name
Address
6) *o a No Yes Nofr)NoTank listed on Certificate of Compliance n No rG"=i No 'a No Yes NoTank presentlv in use r
L4*?
-Month and vear tank installed
2_K.3.lK,Caoacitu of tank (in oallons)u(X,9c!ffi;,t kr e-a+€-t,rzSubstance stored qtPe -Material of construction of tank (steel. FRP. etc.).>FRP[ilaterial of construction of oioino (steel. FRP, etc.)
1-lrIgJ,----i-;--i;.
W@4r
ian,,ir;t' *#itt
Emeroencv Generator tank (leak detection defened)
lnventorv Control/Tank Tiqhtness Testinq
Automatic Tank Gauoinq
Groundwater Monitorino
lnterstitial Monitorino
Statistical lnventorv Reconciliation (SlR)
ffi
Automatic Line Leak Detector
ILine Tiohtness Testino
Vaoor [tr'lonitorino
Groundwater Monitorino
lnterstitial Monitorino
I have inspected th€ above-named facili$ on
day, ysr, llm€)
qcertify
Signature of Owner or Owne/s Representative Present During
lnspector's
Distribution: Whil€-DERR, Yellow-lnspector, Pink-Facility/Owner
Tonk ?faak Arant fi tanub
lf not in use. date last used
lf nnt in rrce denlh of oroduct in tank (in inches)
oWPinino tvoe (oressure. suction.oravitu ete )
lt{anrral Tank Gauoino
\/anar Jt-rlnnitarinn
nthar annr vad methad /indieata name nf malhodl
qtati.ti^rl lnvontnru Flaennniliatinn /SlFl\
Othar ennroved mathorl (inrlicato name of method)
lamaanla.
B
\o
\c
Set 1 6/6*it 6;)',@y'
Automatic Flow Restrictor (il yes, indicate model in comments section below)R5 r-u "
Automatic Shut-otf Device (if yes, indicate model in comments section below)
Continuous Alarm System (if yes, indicate model in comments section below)
No@Records of last Line Leak Detector performance test available on-site No€")No@ No6J
ttlnl?n -Date of last Line Leak Detector performance test
Fail6)Result of last Line Leak Detector performance test 6*) Fair @) r^u @") r^u
Set 2
Becords of last Line Tightness Test available on-site No@ No
4i\(Ye)No@ NoG)
Date of last Line Tightness Test ulrTiq3 -
Failftass)Fail/6.)Fail6)Result of last Line Tightness Test @") r^u
Vapor Monitoring (it yes, use Vapor Monitoring checklist)
Groundwater Monitoring (if yes, use Groundwater Monitoring checklist)
lnterstitial Monitoring (if yes, use lnterstitial Monitoring checklist)
Statistical lnventory Reconciliation [SlR] (if yes, uso SIR checklist)
Yes No
Other approved method (if yes, use other method checklist)
Records of last Line Tightness Test available on-site Yes No Yes No Yes No
Date of last Line Tighhess Test
Pass Fail Pass Fail Pass FailResult of last Line Tightness Test Pass Fail
Vapor Monitoring (if yes, use Vapor Monitoring checklist)
Groundwater Monitoring (if yes, use Groundwater Monitoring checklist)
lnterstitial Monitoring (it yes, use lnterstitial Monitoring checklist)
Statistical lnventory Reconciliation tslRl (if yes, use SIR checklist)
Other approved method (if yes, use other method checklist)
Operates at less than atmospheric pressure Yes No Yes No Yes No Yes No
Slope of piping will allow ALL product to drain into tank when suction released Yes No Yes No Yes No Yes No
Has only ONE check valve, located directly under pump Yes No Yes No Yes No Yes No
All above information on suction piping is VERIFIABLE, use comments section Yes No Yes No Yes No Yes No
oate, tfi/tq/q4T
Signature of Owner or Owner's Rspresentative Present During
lnspector's Signature:
Distribution: White-DERR, Yellow-lnspector, Pink-Facility/Owner
L,ki .:lrr:UTAH,UST.,,PHOG HfiM
H6|ease Fdf.'
,Facility,,|D
Pressur*ed.Prerns.i....iii;iif# xffffi5:t;,iffi;Iiffiifl$$ffi# ..iuffi.. ' rrraciritv
---i>
----
Suction and Gravity,,Flow Pipin$
No Leak Detsction Bequired (must an$wer yee to alt bl lhe lollowing queatlone)
I
e
\s
\cb
Set 1 ranrf nnxb Tank 3 Tank 4
Automatic Flow Restrictor (if yes, indicate model in comments section below)Rs Pz*r,pt nlfr\i)if
Automatic Shut-off Device (if yes, indicate model in comments section below)
Continuous Alarm System (if yes, indicate model in comments section below)
Records of last Line Leak Detector performance test available on-site No@ No€"4 Yes No Yes No
Date of last Line Leak Detector performance tost L B
Result of last Line Leak Detector performance test Fail@ Fail@ Pass Fail Pass Fail
/Set 2
Records of last Line Tightness Test available on-site No&)Yes No Yes No Yes No
Date of last Line Tightness Test ulBlq>
Result of last Line Tightnoss Test Fail@ Pass Fail Pass Fail Pass Fail
Vapor Monitoring (if yes, use Vapor Monitoring checklist)
lnterstitial Monitoring (if yes, use lnterstitial
Groundwater yes, use Groundwater
Statistical lnventory Reconciliation tsl R] (if use SIR checklist)
Yes No Yes No Yes No
Other approved method (if yes, use other method checklist)
Records of last Line Tightness Test available on-site
Date of last Line Tightness Test It I tr ll)
Result of last Line Tightness Test Pass Fail Fail6'")Pass Fail Pass Fail
Vapor Monitoring (if yes, use Vapor Monitoring checklist)
Groundwater Monitoring (if yes, use Groundwater Monitoring checklist)
lnterstitial Monitoring (if yes, use lnterstitial Monitoring checklist)
Statistical lnventory Reconciliation ISIR] (il yes, use SIR checklist)
Operates at less than atmospheric pressure
Other approved method use oth€r method checklist)
'
dA No Yes No No
No
No
Yes
YeS
Yes
No€A
Yes No G)No Yes No
Has only ONE check valve, located directly under pump Yes No Yes No Yes No
All above information on suction piping is VERIFIABLE, us€ comrnents section Yes No Yes No Yes No Yes No
Comments:
Signature of Owner or Owner's Reprssentative present During
lnspector's
Distribution: White-DERR, Yeilow-lnspector, pink-Facility/Owner
A4,ALut 'bu6?Ufil.n:,:U$t.fnOSHfiffi Hififfiiilf,il*
,::r,:,,Rel6ase DdtbCtidn For :Pipln0
FidsbufEeil.Ff$ifig m*$t isEEotBd irdiffit€,qf,t*;Fj$lre$iiilr$lhod;fi ,bo rror$::Be$oifsls :O.(VAs$€l,i FIaa$6 WHe.i.o:No.aPpliq Ss , lf lacility
ilhas 4.fii forlnforma{on dlional:alt o{Icompleietank*i fornl.ggparate
Suction and Gravity Flow Pipirrg r6'J;
Norlrgalt Oagctlon :Begulrud .{ uit anrueir y6;,6i;t, ot ,ifi s,:foilowlftg una*tlot*i
Slope of piping will allow ALL product to drain into tank when suction released
/13D
This melhod of leak detection requires both monthly inventory control reconciliation and tank tightness testing. lf the UST has not been upgraded
(upgraded means that the tank and piping are protected lrom corrosion and that spill and overfill prevention devices have been installed) the tank needs
to be tightness tested annually. ll the UST is upgraded the tank needs to be tested every five years. lnventory records must be kept for each operating
day.
Record of last Tank Tightness Test available on-site No'G)GJ No No
,-.\
&-"-l No
/6-\
Q&g-l
Dats of last Tank Tightness Test r ll re lqt-
Result of last Tank Tightness Test. lf fail, specify in comments section what
aclions have been laken to correct the problem. Has DERR been notified?
Fail@ Fail 6. ) r",,@'^u
Documentation of performance claims for the Tank Tightness Test method is available and shows the ability to detect leaks of 0.1 gph
with 95% or greater probability of detection and 5% or less probability ol lalse alarm (3rd pafi certification)
lnventory volume measurements for regulated substance inputs, withdrawals, '
o-[qt*-
Yes
YesYes No Yes No Yes No
IrtC Utah Tester Certification Number: UT OO55
Tank Tightness Testing method:
Name and company of tank tightness
and the amount still remaining in the tank are recorded each operating day
lnventory is reconciled monthly (sum ol daily overages and shortages for each
month is less than 1% of tank's flow through volume + 130 gallons)
No@ No@ No6)No@
lf no, which months were not? (specify month and year)
lnventory Control records are maintained and available for the past 12 months
for each tank
No@ Nocu @*"No@
Records include monthly water monitoring to the nearest 1/8'No@ No@ 6) *,Nocq
Monthly water readings are used to adjust monthly inventory balances No@ No@ f"y) *o No@
Appropriate calibration chart is used for converting product level measurement to
gallons and is available for review
No€,No@ No@)No@
Dispenser pump has a current calibration sticker or appropriate documentation No€,)@No No@ No
41
Cey
No
NoThe drop tube in the fill pipe extends to within one loot of tank bottom
Owner/operator can explain inventory control methods and figures recorded
No No
2-1tt/Yes,/ No
'#-
*.::ffi
(vei-l
Books appear used and evidence of recent entries is apparent No
Owner can demonstrate acceptable gauging techniques (@ No
The gauge stick is long enough to reach the bottom of the tank /^"(Yey'No
The ends of the gauge stick are flat and not worn down '€")No
The gauge stick is marked legibly and the product level can be determined to the nearest 1/8 of an inch over the full
range of the tank's internal height
No
o
Signature of Owner or Owner's Representative Present During
lnspecto/s
Distribution: Whit6-DERR, Yellow-lnspector,k-Facility/Owner
#Hili:KtII tir glllF$Liiiiiaiiii
ii,iliii jii;iiiiixiLi#ri1liiii#iii
@ G')
fr""-/
@'
,ow
This method of leak detection requires both monthly inventory control reconciliation and tank tightness testing. ll the UST has not been upgraded
(upgraded means that the tank and piping are protected from corrosion and that spill and overfill prevention devices have been installed) the tank needs
to be tightnoss tested annually. lf the UST is upgraded the tank needs to be tested every five years. lnventory records must be kept for each operating
day.
Record of last Tank Tightness Test available on-site (Yes)No NoG..)Yes No Yes No
Date of last Tank Tightness Test tt lralq3
Result of last Tank Tightness Test. lf lail, specify in comments section what
actions have been taken to correct the problem. Has DERR been notified?
Fail @.,,Pass Fail Pass Fail
WY
Utah Tester Certification Number: UT A(rqS-}lructankoftesteriandNamecompanytightness
Tank Tightness Testing method:
Documentation of performance claims for the Tank Tightness Test method is available and shows the ability to detect leaks of 0.1 gph
with 95% or greater probability of detection and 5% or less probability of false alarm (3rd party certification)
lnventory volums moasurements for regulated substance inputs, withdrawals,
and the amount still remaining in the tank are recorded each operating day
Yas
Naz
No
{
Yes No Yes No
Yes G'
lnventory is reconciled monthly (sum of daily overages and shortages for each
month is lsss than 1% of tank's flow through volume + 130 gallons)
G)NoU No@ Yes No Yes No
lf no, which months were nol? (specify month and year)
lnventory Control records are maintained and available lor the past 12 months
for each tank
No@ No@ Yes No Yes No
Records include monthly water monitoring lo the nearest 1/8'No@ @No Yes No Yes No
Monthly water readings are used to adjust monthly inventory balances
./--\( tres ) No No{a Yes No Yes No
Appropriate calibration chart is used lor converting product level measurement to
gallons and is available lor review
No No@ Yes No Yes No
Dispenser pump has a current calibration sticker or appropriate documentation @No NoG'Yes No Yes No
Yes
Yes NoThe drop tube in the fill pipe extends to within one ,oot of tank bottom
Owner/operator can explain inventory control methods and figures recorded
No Yes No
No
Yes No
Books appear used and evidence of recent entries is apparent ffi)No
Owner can demonstrate acceptable gauging techniques ru No
The gauge stick is long enough to reach tho bottom of the tank G No
The ends of the gauge stick are flat and not worn down .,a\^(Y9 No
The gauge stick is marked legibly and the product level can be determined to the nearest 1/8 of an inch over the full
range of the tank's internal heighl
No@
Comments:
o
Signature ol Owner or Owne/s Representative Present During
lnspecto/s
Distribution: White-DERR, Yellow-lnspector, Pink-Facility/Owner
UfAH UST,,,PBOGRAM'^ o"l):)*,ilfi ii htilE*$.:fd$ir$i:iilndirtH$$nt6ffiiig6ffir.dt#iijii
,Fidllty lf
PICase., sircle YsC ::ot, Nb 'for. 6ach .fdf.Ca tantc::::.,::l.:,ti,.,,.,.,Ues]]Cffi ,,lo
.]ll.,moro r$ur,rAnk$r
i:ii:iliirfAN K::if ffi fIT:filESS:i. ,E8Tl Nfi ,,,:.:ii:!f n tls::rdnft4
-)
.,.'...iii.i,',,.rr:..INVEHTOHY,CUN*RO
l ..... riili.:#$:::::: rii;iiliiiii: !: i !
fAnk.$.
: :j: : : :r :iijjj : : | ! : : : tii : : : : :;; : : :t
.i.i,realr.!,i11.
(/;i? da
@
Please clrcle Yes or No for each
L
\
Tnnk'l Taak 2 Tank 3 Tank d
Yes No Yes No Yes NoYes NoThe UST system is lilled by transfers of no more than 25 gallons at one
^time.
lf yes, spill and overfill prevention is not required.
Yes No Yes No Yes Noffit bucket or another device that will prevent
/pleas9ot product into the environment?
Yes No
Yes No Yes No Yes No Yes Nooilu,,"*iondeviceisinstalledonthetank.lfyes,indicate
the type of device in the space below
(l-
'-An
Ball float valve (in vent line)
Automatic Shutoff valve (in fill oioe)
Overfill Alarm
Other Svstem (soecifu tuoe)
For overfill alarm only: ls the alarm located where it can be easily
seen and heard by the delivery driver?
Yes No Yes No Yes No Yes No
Tank I
Yes No
Tsnk )
Yes No
Tank 3
Yes No
Tank 4
Yes NoFor overfill alarm only: ls the alarm clearly marked to indicate what is
meant when the alarm sounds?
TEr*
Yes @
Tar*
Yes @
Tank
Yes 6D
Tank
Yes @
Llm
NoG
Tanks and/or lines are made ol a noncorrodible material (such as
fiberglass) or are made of steel clad with a noncorrodible material. lf
yes, cathodic protection is not required.
No Nod Noe""}-
Ter*
Yes v".'@ Yes
Tar*@ Tank
Yes
Tanks and/or lines are made of unprotected bare steel and were
installed prior to May 7, 1985. !f yes, cathodic protection is required
on or by December 22, 1998.Ure
Yes f-O
Llm
Yes @
Llre
Yes @ Yes
lndicate type of cathodic protection: lmpressed Current (lC) or
Sacrilicial Anode (SA)TC
The results of the last@6atn?llffiot".tion tests are available.
(Tests are required within six months of installation and every three
years thereafter).
@4-.---Tgs
t\o IES NO YES *oa
/-renk' 4. ig,on. (
-ir*
'-3 .47
"",r"1
''V,73uon"1
a-l^*-->,*- 3.9I ,o,,.
Results (in volts) of most recent cathodic protection test.
Name of person who performed t""t Aav.. Sr'' A ^ , ) I (
Test e-E -J I vors
Llm
f,pvorts
Um \-, L.*
" t'9f, vorts
v
volts
Llre
- t,q1
No YesYes No Yes No
Signature of Owner or Owner's Representative Present During
lnspector's Signatu
For impressed current system: The results ol the last three
equipment operation checks are available. (Equip. check required every
Distribution: White-DERR, Yellow-lnspector, Pink-Facility/Owner
A(Yes)
*@
1E-Tank 7)ren*(O Tank 3 Tank 4
The UST system is filled by transfers of no more than 25 gallons at one
time. lf yes, spill and overfill prevention is not required.
Yes No Yes No Yes No Yes No
ls there a spill containment bucket or another device that will prevent
release of product into the environment?
Yes No Yes No Yes No Yes No
An overfill prevention device is installed on the tank. ll yes, indicate
the type of device in the space below.
Yes No Yes No Yes No Yes No
Ball float valve (in vent line)
Automatic Shuloff valve lin fill oioa)
Overfill Alarm
Other Svstam {snecifu tvoe}
For overfill alarm only: ls the alarm located where it can be easily
seen and heard by the delivery driver?
Yes No Yes No Yes No Yes No
Tank I
Yes No
Tank 2
Yes NoFor overfill alarm only: ls the alarm clearly marked to indicate what is
meant when the alarm sounds?
Tank 3
Yes No
Tank 4
Yes No
,"at*@
Tar*
Yes G)
Tenk
Yes No
Tank
Yes No
No6";*
Llm
No{a
Tanks and/or lines are made of a noncorrodible material (such as
fiberglass) or are made of steel clad with a noncorrodible material. It
yes, cathodic protection is not required.Llm
Yes No
Lle
Yes No
Ta.*
Yes 6)Tank
Yes @)
Tank
Yes No
Tar*
Yes No
Tanks and/or lines are made ol unprotocted bar6 steel and were
installed prior to May 7, '1985. ll yes, cathodac protection is required
on or by December 22, 1998.u*-
Yes 6,Yes
Lim @ Llm
Yes No
Llm
Yes No
3-lndicate type of cathodic protection: lmpressed Current (lC) or
Sacrificial Anode (SA)
.rv\L O1wl
lastjue-cethodic p rotdction
(Tests are required within six months of installation and every three
years lhereafter).
The results ol the tests are available.No@ No@ Yes No Yes No
- p.Dl,ors
Ter*
fl,|? uon"
TaI*Tarlk
volts
Tar*
volts
Results (in volts) of most recent cathodic protection test.
,""r, *0rrr,rz SObur*AtName of person who performed
Test Date - tfl ! votts
Llm
- ),D)-uot"
Llm Lim
volts
Llm
volts
No No@@
Comments
Yes No Yes No
Signature of Owner or Owner's Representrative Present During
lnspector's S
For impressed current system: The results of the last three
equipment operation checks are available. (Equip. check required every
Distribution: White-DERR, Yellow-lnspector, Pink-Facility/Owner
W>nt)riciirtv io nU
GheilkliStir,r,rr:.ri..l . .... :1..,,.r.i.l..l.r.'.. , .,,.....i.:,::
Phase qgqrpletB all in o tion for eabti laruc U-ae,,adttbnal lorms as neoessary if {ro t*iitv'f,as rnoie fl1an 4 tanksj:
SPILUCIVER FIlJt' PHEU.ENTION
e6Hnos.ioN:. .F:HdrEefioN
--7
N]I
,l+*
wu
*-s
x
vo,*s
+L
X
(,
++3
X
x Ro-d J-a-.ku-ts
rD 4 looorll
1-
I
F\,- - r ..\= T<-r "l^f- l-,.i.--.-,U ,J t -
:tC-
.
DEPARTMENT OF EI{\TIRONMENTAL QUALITY
DIVISION OF E}.IVIRONMENTAL RESPONSE AND
150 North 1950 West 2nd Floor
Salt Lake Ciry, Urah 84116
(80t) 5364100
(EOl) 359-tt53 Fax
(Eot) 5364414 T.D.D.
REI\,IHil+frASl'1 ,"
_ _Dlv. oF EIJVIR0NMENTAL
RESPONSE AND NEMEDIATION
UTAH DEPABTMENT OF
ENVIHONMENTAL QUALITY
Michael O. Iravitr
Dm.e R. Nielson, Ph.D.
ExEutivo DiEtor
Kent P. Gray
Dtoctor
Govoor
TO:'ffiAex 5'
RE:N.OMPLIANC F UNDERG
(l-4.. Wn u UTAH; FA
To continue io maintain a valid Cenificarc of Compliarrce, r
and Starc Rules and Reguldions. A review of our records
lacking:
-cl3
FROM:Yhu^r c,1 ,lJ.lo*t-€_F
NDS KSA
the iaciiiry muu be in comphance with Federal
have shown that the following information is
tltlI]
You must documenr that you have leak detection on the following items:
Pressurized piping (must have automatic line leak detectors by December 1990).
Tanks and piping (because of the age of the tank there musr be a leak detection method in place).
* The above infonnation must be documented on Notification of Underground Storage Tanks, EpA Form
7530 @evised 9-89). Any other upgrades or changes to the systems must also be marked on this form.
t I A Notjfication Fonn, [ ] registering or [ ] upgrading needs to filled out and submitted to this
office (use EPA Fomr 7530 (Revised 9-89).
tl Arnual Tark Fee Assessment(s) remain unpaid. Please submit a check for
This will cover the fiscal yea(s) 1988, '89, '90, '91,'92 and '93.
t I Annual Fees for the Petroleum Storage Tank Fund remain unpaid. Please submit a check for
$This would cover fiscal years 1991, '92 and '93. The amount needed to
bring your facility up to compliance to the current quafter is $-.
i I You have failed ro meer lhe requirements ot your compliance schedule.
tl The release #has not been characterized or maintained its cleanup schedule
to the satisfaction of
Secretary.
your project manager, and the Executive
Xf other:\'Fe,g-- ',
f a,ert Z t4ets:.
t/( Please retum a copy of this speed memo with the above items to speed processing.
The above information must be submitted to this office by If it is not
received by the date specified,
Compliance. If^ you have questionsSc,F (\\of r..; o tsorFt
conceming this matter or need any assistance, please contact
6-4100.
on recycled paper
L
2fr6f,e )ur rra Zet) and tr ft 'ww P 7w k#'
r\i\ODL"^
SYS['EtonS
COVTPANY
124 North 22nd Ct., Grand Junction, Colorado 81S01
Office: 303/243-4149
a Design a lnstallation o Materials Surveysa
Deoexrber 27, 1993
It[r'. Charlie Hjorth
C.H. bbrvlces
11120 West 800 North
lvtapJ-eton, Utah 84664
Dear I{r. Hj<.rrth
This letter is to sunrnarize ttre rr:su1ts of the urdergrourrd fuel storage tank
cathodie proteetion system ne irtstalled at Maetex Supply's bulk plarrt in provo.
Or O:tr:ber 27th zurd 28th, 1993, wt,. j..rrstal-ted ei-ght :-mpr-:ssed. gr-rrrerrt aucrdes inI ft. deep holes around the six tanks. The anodes were conne:ted to a Lrrriversalrectifier via pnsitlve cables laid in saw cuts in ttre pavenent. The rngative
cotruectiotrs to ttre tarrl<s were rnade aL ihe verrt pipes next trr the buildirre. A
cumull negative cab]e is also laid irr a sawcut in ttre pavenent. It terminates at
Lhe 11eg41irrc terminal ilr tte regtifier.
Taul<*ro-+sol1 potential readlngs were taken before and after the rectifier rystemwa$ t-li'tted orr. Ace,urding to the griteria fty corr<.si,crr prole,;tion as establishedin the llatiorlal Assoclatlotr of Oorr<xion Engineers Becornnerrd Pracbice Rp{2-8b,
zut utrdergrouud taul< is s.thodically proLected if the tank's voltage ptitential isshlfted frorn lts natural voltage of approxirnately .0.60 volts k; a mlmilum of
-0.85 volts. AIt 18 readirrgs taken by this crxr,csion errgirreer prion ro turningou the system ranged be'lween 4.57 and -0.7Q volts. T'his irrdicates the tankswera oorrodiug. The rate of eorrosion depends ar the soil type irr whi:h thetarrks were buried and the type of beskfitl placed irrouud them. In drillirrg theanode holes, ue drilled throu#r clay whiCr is eorrosive.
Otr Octobet Zfl, 1993, tlris engineer turrred o,,r the cathod.ic protecLion system.After adjustirrg the current output on the rectifier, 23 new readirrgs wlre takenarou[d the tanks and dispensing islands. AU readirrgs were betw<Nrrr -1.21 arrd
-7.82 volts. The lqpest reading was betweerr ttre tan}s ard is well above the-0.85 volt level needed for s.fhodic protection. Ttre kr-ighest readirrg is txr topof an zurode. Therefore, the tarrl<s ard rlre prcCuet oipirg tc the islauds are :rcxlp-rotected as evidenrcd by the tank-to-soil potential readrngs. The rectifieroutput was set at 21.8 volts and 5.25 arnps. Thre arryrcrage is what protects thetanks.
The curreut output should be read antd reoorded ortre a rnrnth. The roltage will
trr-rt' ehauge frcrn tlre present 21.8 volts. The systern should last a rnirrinr-un of 20years. Within the rext 30 days I wilL submit & rnrre xrnprelreusive naport forycrr files.
Yours truly,
il**S,/^/df ,$I,f'H[,KTHTllo?1"
Ilarrs Schrmldt
Pre.,-ident & Corrosi-on Eugina;r
o
JAN I q lssqtl-
-,?';'a$5,rHJ$,39#5$[t[-
;.-.: .1 -TD [c-r',8 CI iu'it !-'r)tC-L
i-nt
Michrcl O. l.eavio
Grymr
Diuroe R. Niclcon. Ph.D.
Eretivo Dictc
Kcnr P. Grey
Diroac
TO:o-\ cr. 6r.
DEPARTMENT OF EM/IRONMENTAL QUALITY
DIVISION OF E}.IVIRONMENTAL RESPONSE AND REMEDIATION
UTAH OEPARTMENT OF
ENVIROt-lM6f'lTAL.
150 North 1950 West 2nd Floor
Salr llkc City. Uralr 84116
(801) 5364100
(801) 359-8t53 Fax
(Eot) 536.1414 T.D.D.
DIV. OF ENVIRO
Ar'{ I I 19
(si,qfi0il
RE: NON-COMPL IANCE OF UNDERG
f rru UTAH;
ROUND STORAGB
FACILITY ID# IOC,O i
TANKS AT
t1l
i,
$r -.)
tlrlrI
To continue to maintain a valid Certificaie of Cornpiialce, the iacility must be in compliance with Federal
and State Rules ud Reguluions. A review of our records have shown that the following information is
lacking:
You must document that you have leak detection on the following items:
Pressurized piping (must have automatic line leak detectors by December 1990).
Tanks and piping (because of the age of the tank there must be a leak detection method in place).
* The above information must be documented on Notification of Underground Storage Tanks, EPA Form
7530 (Revised 9-89). Any other upgrades or changes to the systems must also be marked on this form.
t I A Notification Form, [ ] registering or [ ] upgrading needs to filled out and submitted to this
office (use EPA Fonn 7530 (Revised 9-89)).
t 1 Annual Tank Fee Assessment(s) remain unpaid.Please submit a check for $
tl
This will cover the fiscal yea(s) 1988, '89, '90, '91,'92 and '93.
Armual Fees for the Petroleum Storage Tank Fund remain unpaid. Please submit a check for
$-.Thiswouldcoverfiscalyearsl99l,,92and'93.Theamountneededto
bring your faciliry up to compliance to the current quarter is $
t I You have failed to rneet the requirements of your Compliance Schedule.
t1 The release #has not been characterized or maintained its cleanup schedule
to the satisfaction of
-,
your project manager, and the Executive
Secretary.
fxl other:L
,r J1 lu.at Z g?.eil !.
fX Please retum a copy of this speed memo with the above items to speed processing.
The above information must be submitted to this office by a If it is not
received by the date specified,
Cojnpliance. If^ lou have questions conceming this matter or need any assisunce, please contactX\ctrprr l\o\fry at (801)5364100.
on recycled paper2fr6f,e n€e/ @ /Vear) hnd tr la ffiw P 7W rc#'
).o r
Michacl O. bavitr
Dm^e R. Nielson, Ph.D.
Exalvo Dlrtor
Kent P. Gray
Dtoaor
Gomr
)
N'a
i
J
1t
:l
j
1
i
I
1
--. -- -
- ^
-\-
- ^
-A!-:-i---= i-j, *irC--
DEPARTMENT OF E}.I\4RONMENTAL QUALITYDIVISION OF E}WIRONMENTAL RESPONSE AND REMEDI,ATION
150 Norrh 1950 West 2nd Floor
Salr I ^t c Cir.v, Utah t4l 16
(Eol) 5364100
(801) 359-t853 Fax
(801) 5364414 T.D.D.
TO ,'t'{tr,.\ e-o
\\
1_
DATE _ o --7.
LI ('
RE:N.COM LIAN C E FU ERGROU STORAi\5 \/!A l,r,i UTAH; FACILITY ID#
ETA SAT
?o
C 1
To continue to maintain a valid certificue of compliance, ttle facility must be in compliance with Federaiand State Rules and Reguluions. A review of our rccords have shown that the following informuion islacking:
t I You must document that you have leak detection on the following items:
! f Pressurized piping (must have automaric line leak detectors by December 1990).t I Tanks and piping (because of the age of the tank there musr be a leak detection merhod in place).
* The above infonnuion must be documented on Notification of underground Storage Tanks, EpA Form7530 (Revised 9-89)' Any other upgrades or changes to the systems must also be marked on this form.
t I A Notification Form, [ ] registering or [ ] upgrading needs ro filled out and submiued ro rhisoffice (use EpA Form 7530 (Revised 9_99)).
tl Annual Tarrk Fee Assessment(s) remain unpaid. please submit a check for
This will cover rhe fiscal year(s) l9gg, 'g9, '90, ,gl,,gZ and '93.
t I Annual Fees for the Petroleum Storage Tank Fund remain unpaid. please submit a check for
This would cover fiscal years 1991, '92 and '93. The amount needed tobring your facility up to compliance to the curent quarter is
I I You have failed to meet the requirements of your compliance schedule.
tl The release #has not been characterized or maintained its cleanup scheduleto the satisfaction of
Secretary.
your project manager, and the Executive
Xf orher:\l\
(-L(r (i. lu..trt 'l ,4?-ctJ --,
[X Please retum a copy of this speed memo with the above irems to speed processing.
The above information must be submitted to this office by If it is notreceived by the date specified,
Compliance. If- you have-Y\crcprr t\\tr\!r;questions conceming
ar [phone]
this maner or need any assistance, please contact
Prinleo on recycled paper
eak Detect ion Inspection heckllst
ll. Locatlnrr cf !ank{S'i. $wnorship of Tank(s
ill.lank lnfcrmation
tanks.t(tilr$rnotaf,aslaRs.€acrr l3sri:tylniilrrn&Bot"r tu'ct,rnpiauJ Uvixs.tIrlcrmaEolt sdditionsltoralicomr)l6toltti9illd y ran@, (o Tank 4I ran$l_1 rant#z-Tan:{ srgsamly in usa
,/tl fiot. nat6 tas used
l5Moffifi arlc, Year Tanx lnstJtllgd fH*€stirflats o{ K -knownl
----2
lok 4K JRloY(0f tok -utVnkd
tr'v VuoxruDrEr-tCr4l),nleu
,rD$uii'ad.l,?A u nmrellg ror ssch'hYlft'#lpton rn*rmdgl us
Manual T;mi{ GatJginQ {only tcir mtlk$ tJnder 1.000 0al.)
Mar\uBl Tenk Garrgi!'tg and Tank
(oni'v fcf lAnt€ wdflf a000 oal.!
'liGt'{n{}$s 'f€$ing
,/r'TankTlghftw Testlng $ixt lnventcr/ &]n&'r:i
AutorYr&i:6 Tan*t GaqruiqJ
Gr$r,itr}+tatgl'
\Jao()f
!nisffititiel
}d tor p6rng.
,r"
lV" frl" Holease Oetection For PiPing nwthod{sl}
-"
Chock t''r$ roloe$a
PYlsr,tm.t PiPlrXlIlrr.c,)< Goe iype of PFing tor aach Tank
g&Et Ptctt\1
!/'(/
l;l/'t/'
\/3pcr
tz'/
vrrth
U*r;i fiinss,,i
U'r$uridural0r
/ 5039^-i3
Ownor f{amo lGoiporadon,lndlvldual. Publlc Agoncy' or orrlt ongty):
lt/"d,y E S
grrost A#drEtt loo s l,Lvrirr AX
iounty \rff
$llts 7:16 Cods
)
er appllceblo
gtrosl agarors or StetE Sood, ee
eounty
Cir'/ OY Clty (!isotoEl;sure 7)p $*ic\fO
Acan C{do
Stz\,'<-
Fhono Numncr
al\o 31V - 1bq4 Nunrbot af Tants rt Tltle [.oc*6s;t:6
f:or.met PBrlon At UIiT Lousi.U,n Ptrron@ s Ft',;iltty l$Jr:
lf smDir€d,1' cr lsss ry pmsuc{ in unlt
lriarcnal oi Cnnstuction (E-&$imatts or K-knownl
C;apecrtv oi Tank (in gallons){H-esfimala or K-knownl
Subslancs $torotl cr K-knownl
If. A" Il*lease Detection For Tanks clr€ck fis rol€sso
Othar aoprovad rndtOcl iwrite in nams ot rnBtmod)
ALlr.onlRtic L:ng Usak oetoaors', aQiS
iilnBck Jns o, tha
IV. (:, CIorro$ii$rt
:,Hdi
Clrr:ctctl ort,:$eiidfl i
vsrfil rote#tien
ilie*:orl (irl.:licdts dstg!
5 - i;i,'ili nrfi ti $r'ii$6l0an instrtNi$rl linti;tsHts {lettl
\I. Site inJartnation
Gor..$rilri,.trl$3$srvatcn86ridcomm6'Its(ucin,tyobs8'vatjon3,grourdwat8fl8vc.eE.}-
named facilit/ on
t
t-'
I rlse€cior' 3 $ignaura:
Sldi65-!
thst I harre inspqdBcl fia a$rye
ila-U/r"--"--Dat€:Z
I1) tq
3Le<-
tl,nlul
Leak Detection or in
Facility lD f lDDn t1t
urized tEsil. It thls lacllity has
ptBng:
Set 1 P",jqaoUf Tank 1 Tank 2 Tank 3 Tank 4
Automatic Flow Restrictor V
I
Automatic shut-off Devica
@ntinuous Alarm Syslem
and
Set 2
Annual Line Tightn€ss Testing Mlar 72-
Vapor Monitoring
lf Vapor Monitoring, doq,Jmentation of monthly
monitoring is available
lnterstitial Monitoring
lf lnterstitial Monitoring, documentation d monthly
monitoring is available
GrounGWater Monitoring I
lf Ground-Water Monitoriq3, documentation of monthly
monitoring is available I
other Approved Methoct (sp€cify in comments s€clion)
Une Tightnes Tosting (required every 3 ysars.)
Vapor Monitoring
seconoarv containment with lnterstitial Monitorirg
Ground-Water Monitoring
Other Approv€d Method (specify in comments section)
No Leak Detectlon Requlred
(must answer yes to ali of the followlng questlons)
Op€rats at less lrlan atmoBpheric pressure
Has only one check valve, which is located clirectly
unCer pump
Slope of piping allorrrrs product to drain back into tank
when $Jction releas€d
All above information on suction piping is verifiable I
Comments:
certify that I have inspected the above named lacility on y.r'(Prmm)
lnspector's Signature:Oate:10 ?s
S1oO59-5
i
I
I
I
I
I
I I
I I
I
a
lnventory ontro and an Tightness Test n
r-<uv
o
=LC-
Facility tO *1:
Nar,"e and addres ol tank Ughhess bster:
Metira-. ol tank dghtnoss t€stilxg:
tl thls lacility has mors than 4 tanl€, ploas€ photocopy thls page
, complate the inlormation lor all addhional tanks.
information rfo tankeachal
q Tq** g Tank 4(Tl nkli Z.) rpk, I r-tIl4av(Date of last tank tightness tosl.
Y Y v Yvv
Did tank pass tesfl lndicate yes or no. lf no, specify in
commonts seclion below the status of the tank or what
actlons have been takon (e.9., has stato b€en notifiod?)
Dodrmsntalion of deliveries and sal6s balances with
dally measurements of liquid volume in tank ars
maintalned and avallable.
Overages or shortages are less than 1% + 130 galg ot
tank's tlow through volume.
I
lf no, whlch rnonths were rnr?
for each
yes no IOwner/operator can inventory control and flgures used and recordxl,
noy€8Records include ronthly tvater monitoring.
t/yes noBooks appear ursed and evldenca crf recsnt entrias ls apparont.
yes rb
--roks are roconcilecl monthly
yos noApproprlate calibratlon chart ls used for calculatlng volume.
\/noyesDrspenser pump6 lrave cunent calibration stick€rs.
yos noThe drop tube in the fill plpe sxtends tcl withln one toot of tank bottom.
yes noOwner can demor6trate conslstency in dipslicking technlques.
noye$
yes rro
noyes
Mcnthly rirater readlngs ars usod in calculating monthly lnv€nlory
Th€ dlpstlck is long enough lo reach ths bottom of ths tank.
The onds ol th. gauge stlck are tlat and nol worn down.
balancos.
Yesl n nolThe cJiosllck l! marked legibly and th€product lev8l can bo determin€d to the nearast one€ighth
of arr !nch.
y6s noThs tai!k has been tested within tho yoar and has passgd the iightnoss t€st (if n€cossary).
yes noA third-p;;i'' certlflcation o, ths tank tightness test method iS available.
yes racTank tester complled wilh all certification requirements'
lo 4=lnsp6etor'. Slgnefurr:
noyes
(k,'nmonts:
2{,U14/t4*Date:
Monitoring and locting are maintained and avallable lor the past 12 months.
sroil-r
.&rErY*t9''r(!Et", {a"q r: {I?{Trii,ifrtri -1itr'5 ry-'
I
,./
,l/
t-/
cr.,,t4l". i,o 'zt(a)v
<.-
--)<6-\U.\
l
_t
I
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AD
1
\
in\
^{
FACILITY ID.
llon-Marketer Discount
--revLcus PoIlut. ICn ncloence
PST PROCESSING CIIECKLIST
Year ql
Unacceptable AccePtable
A(F
<11
Not
Applicab
/
- IUST File
- Form Includeci
: /' lt F.'l
(/
TTT
- Verify tank/1inesvs registered
- Documentation ok?
rV, F-leld D+r
- Rate ok?
Fund Paid
- FY 9L?
f ees Pa id 'i l:I
- FY 88? Y,
-FYSg? V
-FY90? Y
-FY9L? Y
Compliance
/ - Compliance outstanding?
MVAC:\ - Leak detection required & in use?'ll' t
qg/l l'yikl llotif ication up to daie & compl-ete?
\0\L
ytN Y
Y/N Il \/
Y/N Y
Y/N v
r-ro\ )'-rF'
Y/N v
Y/N \I
Y/N t/
r qJ* L+3
o^uQ//
LD tr7
,/'
Date Qualified
?.evieiv completed and cer-,if icate issued by
suPPoRT\CE \ CHECKLI ST . PST
q-27*q/
)\.
FACILITY I. D. #
FROM:
h:ltil-TH
Norman H. Bangerter
Govemor
Executive Diretor .;
DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH
Bureau of Envrronmental Response and Remedratron
288 Nortn f .i60 r'r'est. P O. Box '16690
salt Lake city. utah 84116-0690
(801 ) 538-63s8
iI, ffitj,*il;;1/ii#
-/
TO <> 4,-
?o
il",r::$-r.AL,:',::ll.t-rf.tl\l
Your application for coverage under the PETROLEUM STORAGE TANK FUND is
incomplete. The fbliowing additional information is required before your application can
be processed.
[ ] The results of your Tank I Line Tightness Test and a copy of the field report need to
be submitted to this office.
[ ] You have not completed the form declaring "PREVIOUS POLLUTION INCIDENTS".
Please complete the enclosed form.
[ ] Annual Fees for the PETROLEUM STORAGE TANK FUND remain unpaid. Please
submit a check for $ This would cover the fiscal year '91. The
amount for the current quarter only would be $
[ ] Your "APPLICATION FOR NON-MARKETER DISCOUNT" is defective for the
following reasons:
u-Q
b<] A Notification Form, registering or upgrading your tankg, ne,edq to be,filled out and,
submitted (use Form 7530 (Revised 9-89). pc, . .'*.'* lL- k' '*''< *rL /'*e I *-' k -
,l o {*. k.'t 1: ,^ g -e'-.-. ut i , ,*=
[ ] Annual Tank"Fee Assessmerris rerriain unpaid. Please submit a check for- - $ . This will cover the fiscal year(s) '88 '89 '90 '91 (circle the applicable).
[ ] The release #.
schedule to the satis-atisfaction
Executive Secretary (UST).
has not been characterized or maintained its cleanup
of your project manager, and the
[ ] Other (beiow):
Please note that you will not be eovered under the PEIROLEUM STORAGB TANK FUND until the
above mentioned items are completed. If your are qurenfly a LUST sitg and your Fund application has
been approved, any further releases will be covered by the Fund" If you have any questions concerning
this, please call the Bureau of Environnrental Response and Remediation at 538-6338.
vDvO
--<) /
/"t .rrrl)
:;- '"\'.i"i
.
ft Mqctex Supply Cotnpan!, Inmffiffiffi$V6D
7OO SOUTH UNIVERSITY AVENUE
Phone 37$8694
H&R2s ffif
PRovo' urAH 84601 urAr-i DEpr. CIFItF LTH
BU*fi ,4r r i.rrf Et\lwnsi{ i! SFITAL
Fij$_itrf r*qr a illn E?rl' 1'p1 irlrTf nhl
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ej.::;sr i.*" j.t c*r-.tId hfi're hc,r*n "li.rn "i-hi.r-*ri, hr-.rt I;*m rtc,t:ilrre. Ln;lny c:fr{t*]
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hy i"Jn*;l*r:f't [j'::r,tllr:l'inicni. j.r'rc, wiii.r:i-t *,trr:r."tx l*rt'I r'rcrtic;ri::1e tr,:'tcrx r.,f
t: {:.r l-r'l: i-r.ffi i rr*. h i c' ir "
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l.mt ne i;:r'!r.lr.d l;hctt-.ri.cj '.,,r.,1r r.tq*e*,1 .:rl'ly arjrJitirinal. i.rrf'*r-n.ati.r.,rr"
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Pr- tlr:i i ilnr: t
FOOD MARTS - TEXACO PRODUCTS _ GAS CARD
HECEIVED
HAR 2 s lsf
UTAH DEPT. OF FIEALTH
BUEEAU r,rf ;idu,r: i: ;irtiildT,AL
PFSPONST' &\ft, ai;';t " I'il ir':"rr'l -
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UTAH DEPT. OF HEALTH
BUBHAU GF EN\f I T'iCi :}jN?llTAL-.?ttl't t trfi' o iln rrr:r F :.-!1 I A.Tl oF-;
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REOffi!VED
t'f$R 2 e ffil
UTAI.I DEPT. OF HEALTH
BilPq4,U CIF TN1':P,r':" 1T}.!TAL't:i;$PnN.+r: a ND trEnr rirt A.T!4.,'
a
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(
CERTIFICATE OF PRECISION LEAK TEST
AES WEST has tested and certifies the following
Certification #
u-8185-0
I
DATE Ttetso CERT1F;ED TESTER STEVEN B. MARTIN # UT0121
LOCATIO N MAETEX SUPPLY BULK PLT.. 7OO S UNIVERSITY AVE., PROVO, UTAH
1
2
3
4
5
6
TANKS
2K-KER
TANK
PASS
LINE
PASS
3K-HO PASS PASS PASS ANY FAILURE LISTED MAY REOUIRE
NOTIFICATION OF AGENCY1OK-DSL PASS PASS PASS
1OK-REG PASS PASS PASS
1OK-UNL PASS
PASS
PASS PASS
lOK.SUL PASS PASS Recertification Date Recommended
JULY9,1991
AES WEST
4885 South 900 East, Suite 305
Salt Lake City, Utah 84117
801-265-0055
(
PROD/LINE
PASS
flH5
filroclrtrd Envl ronnrntrl Eyrtrmrr lne.
Involca Addrcgc r Tenk Locatlon r
IIAETEX SUPPLY BULT PLT.
7OO S UNIYERSITY AYE
PROYO, UTAH
4453s700Et3()3
SALT LAI(E CITY , UT A{lO7
l-aoo-333-2379
U.O. lr alBS
I. D. llunbcr r
Tcchnr.al,rn r gI
Tcch. rtUTOl2l Y!n, ! 8503
D.t.t 7-9-!N, Tr.re Stlrtt OTIOO Endr 2O!OO Countyr llTF.clltty Phon.rt 8Ot-373-8691 Broundrrtcr Depthr IO'EST Bluo Prlntar llA
Contact r llAX E66ERTSEII DetorTlno .yatcr ,.. fLlledt 7-9-90 A7.OO
TmlTrnlr Crp.altt
2ll
3t(
10t(
t0[
t0l(
l0;
Produot
IEi
Io
D5L
nE6
utL
sUL
Ftll/Yent Produot Tyoe 0l YroorTrnk Yrpor Llner Llnr 'Rcoovcry'Puro
Typa
Inchea olIrt!r/Trnk
o. 0r
o. or
o. 0r
0. or
o. 23i
o. 0r
Trnhllet!rlel
I
I
II
II
I
2
3
a
5
6
Prss
PASg
PASS
PASS
PASS
PASS
PASS
PASS
PASS
PASS
PASS
FAIL
Plss
PASS
PASS
PASS
PASS
PASE
Addltlonel Infornetl.onr PRODUCT LIIIES IERE TESTED AT 45 PSI FOR l5 llItIUTES
HO -.O29 EPfl DSL -.OO2 GPH REB -.OO1 6plt UltL -.-OOA GpllsuL -.ot2 6PH SUL AilD UIL LEA!( AROUHD COLLAR OF FILL pIpE, lor DOUN
SITE LOG TIIIE
S.t Up EqutprBlrd Produst Linur
Blad Yrpor Linor rBhd Vcnt li,h.. r
Blod Turbl,nr rBtrd Suotl.on Purp rRl,rrrr Inrtrllrdr
Thr.. .yrtri .nd r.thod r..t. thc arltorh ..t torth ln IIFPA 1329.
Any frilurr llrtrd abovG nty requLr. turther ectLon, oh.ok ,lthall rcguletory rE.nor,.!.
e)
b,
Certlfl.d Tcohnloten Slgn.turc Detc , 7-/r-?2
FTIEIAIC' TMfi I LI]:
"EAT
FEEI-T!
IIAETEX SUPPLT
PO BOX 450
PROVO, UTAH 8{603
srs
srs
srs
srs
srs
srs
scT
TEII
TBII
TBII
TBN
TBN
OBrOO
OArlS
f,A
IA
OBr l3
IA
lto.
Asw
sTsIEilSElIt,IROil}I ElITf,Lf,SSOIIRIED
IIII'fiRSITT f,IfiIIE
f,(
1fr(
vents lli[
rtrIEil
SPPTI
lffiIEII SIJPPLY,?OO S ffiIIIERSITT f,tfi,Pffiilfll,lll
)
tsl
fl(
NtIGR3l(
HO
it
ffiL
I ffi
E
gt(
RE
tr
0
tr
0
l-J
00
tr
0
0
I I I I0
/1
lrt
IIII\
Site Llwut For i
tr
I
I
AES / Elrt=r(=ltman Pr-eEt l--l-t=rr
aa!! ! ,oo r r rl teLr Lerr cttt ' tlt aalo
L eal.G'T'eEt
l-loO-ltl-at?l
I Technl.cian UTO12f I Caltbratlon Value 7 y UIIITS ,o51ial. I
I Dete 7 /9/9O I System VarlatLon I UIIITS I 6PH I
I Tfune Started 16121 I HI6H LEVEL ( FULL SYSTEII ) I 5-.5_ | - ,oJ 2 |
I Gallona 2K ! LOTI LEVELil }IID LEVELil I
I Tank Dlaneter 64ll I PRODUCT LINE
I Ground llater LO'+/- r TEST IS lbplSSeU ()FATLED ()TIICONCLUSTVE I
JI TEST CONDUCTED AT 7a,1 IIICHES I 6RADE LEVEL AT /<>f I}ICHES
It.I InrI ::tt
$ii: riil
:::IHl:
in: [il:
[ii: {tr
'T'[i:
:lii: riil
T'I l'{ [i* f,1 ]t l',ll,,l'lll'liil:ii:
'ili'rr:rr l',1 ll.:l iiiil ll.:l liii lfi:
,!i:'till
FOCUS l,EE Ll l,0E T O RI} ER HO , B 1S5A
rr Notea
HAETEX SUPPLy BULI( PLAllT, 7OO SOUTH UNIYERSITY AVE, PROVO, UTAII
Thie Le a htgh level test conducted et 1O4i, vith a l-X calLbratlon.
Grade level Le 1O5i1 D€EEUred to the top of the f111 plpe.
I{EATHER t hot and sunny
!;:l
L
E
U
E
L
T
E
H
P
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l'.{
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il r...1
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4
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ilt:
T@lFgl|-t+ ror({\
I I
I
-tr-t-t.-..q
/t
Froelrtrd Envlronmrntrl Eyrtrmrl lncl.
TAIII( RESULTS
4{55S7008r303
SALT LAKE CrTY , UT. e4l07
I -800-333-2379
Tcchniclent UTOlzl
Produott KEB
6{1 Ground Uatm Lrvclt lO'+l-
5
;
I
III=
Iork
Drtot
Ordu llo. t SIACA
719t9o
2K
Tankt 2
TLnrt 16t2l
Tank DlenetcrrGallon; t
Data
CallbretLon t
Anount Utrdt O.OS
RmdLng Zont Stmt 25O to 263
Lcvel Sogrtnt Fron t 26tt to 599
Tcnp Sogrrnt Frort I to 399
Volunrr 2OOO
Produot Lovrlt 1O{.OUrter Lrvrlt O.O
Spcclf lo Bmvlty t O. 76O0OOCorffloL.ht Of Erpenrlonr O.(X)O5278
Trnh DLultr t 63(XIOO. O
.r rrrrrt.t!rralr.rtlrltl.!l!t..t.t RCgUItl
Changr In Crllbretlon ZonoCrllbmtlon Unit (grl/unt t )
.70r O.OOOTI
Stmtlng Tmpmturr(F) r 76.9O
Hred Pruiurt(ool/ln (Btr) ) . 81. 12
Surtror Aiu(rq. lnl . 13.67
Totat Chrngr(gpht r -O.03942
Tcnpmrtlm Eflcot ( gph l r -O. 01636llrt Chrdgr(gpht r -O.9!!OF
aalraalrtll
AEs / B-'e cl<rnErraat! r ,aa I a r.^, tt!t P--ee l- E l- on I-eak 'Teet
Lax! cttt , ut I a t o t a t - t o o - I r , - t t ? t
I Technlclan UTOl2l I Crllbretl.on Velue 1; UIIITS r6J- GaL. I
I Drte 7 /9/9O I SyEten Varlatlon I U}IITS I 6PH I
I Tlme Started 17 t37 I HIGH LEVEL (FULL SYSTEU) I Z I -&'o/ I
I GeLlone 3K I LOT LEVELil }'ID LEVELil I
I Tank DLaneter 63'I PRODUCT LIT{E
I Ground tleter LO'+T- I TEST IS dPASSED 0FAILED ()INCOIICLUSIVE I
I TEST CO}IDUCTED AT ?g IllcHEs I BRADE LEVEL AT to6 IllcHEs
d:rl
L
E
u
E
L
T
E
H
F
t,l
I,t
:t:
':['
T'!iii:
[:::t::rl
r:::l!:.
Ei Fr
LX 4C
<-4.
nrE:
ril':s{il
T I f.1H* il I f'J IJT lil:i
Tdll.{h: :l, H {:l
,lir, tiX
FOC lJs +,00 L/ L OO T ORI}ER HO. SI85B
r. llote!
}IAETEX SUPPLY BULI( PLAIIT, 7OO SOUTH UHIVERSITY AVE, PROYO, UTAII
Thl,c 1g a hl,gh level teBt conduated rt 94i, ,lth one l-X and tvo 2-X
Grade levcl ,.r 106r, mc.Bured to the top of the flll plpe.
IEATHERT hot .nd .unny
t:It::[ r,,,11:l: l:
t uPIo!J..r
LgveL,,
T6,,..PoftAro' G
- --rfrlrrl
I
I I
eronlrtrd Envtronmtntrl Eyrtrmr; Ine.
TAIIK RESULTS
Iork Ordrr llo. t
Drto t 7l9l9O
Erllonrt 3K
I8t8sB
CelLbratlont
Anount Urcdt O. tO
Rcedlng Zonr Stert 583 to 586
Lovcl Sogrtnt Front I to 2Ol
Tcnp Scaront Fro;r I to zOL
Yoluner 3OOO
Produot Lrvrlt 9{.Olhtrr Lovrl t O. O
Spoolflo BrevttYr O.71O(X}O
Corfflol.;nt Of, ExplnrLont O.OOOTOAO
Tank Dlurtrr I 63. O
4{35S7008t303
SALT LAKE CITY , UT A4LOT
1-800-333-2979
Trchnlciant UTOl2l
Product t ll0
631 Ground teter Levclt 1O'+l-
/fii5
Tenkr I
Tlner L7t37
Tank Dlerctcrt
Dete 8 I r l tt ! : !t - t t E r I tt t ! I - ! - - ! t ! a a r a - 3 r r t g !: r ! 3 s
Chengr In Crltbrrtion Zonc
Crllbrrtlon Unlt(gel/untt )
Totrl Chrngr(gPhl r
Trnprtturt Ef frot ( gPh )
llrt Chrngr ( gph ) r
r L77r O.00056
Startlng Trlpmrturr(F) ' 81.93
Hoed Pulurr(ool/Ln (Btr)l '66.74gurfror Arm(eq. lnl . 13.79
-o. oo2l3r -O. o2173
o. ot960
tr!arallltlaa!t!!llrrtlatSEla=ElE Bcrultr 3=!B3a!!t==I-tl-s!tEtt!:!a=EBtt!tlt!t=3!
rattartt-t
AES / B=oel<^fi rr Pret=l--l.on neak lf -staall l aa a a t( taLl Latl t!lt r u? lalo? l-toc-tll-llrt
I Tcchnl.cl.an UTOl2l I Callbretlon Value f s-UtlITS ,oJ- Gnl. I
I D.te 7/9190 I Syrton YarLatLon I UTIITS I GPH I
I TLme Startcd. 13t22 I HIGII LEVEL (FULL SISTEII) I 3o I ..r t/ 3 |
I Gallonc 10K I LOT LEVELil }IID LEVELil I
I Tank Dlanotcr 95r I PRODUCT LIIIE
I Ground I.ter l0'+l- I TEST IS ,Aprssso ( )FATLED ( )rttcoltcLusrvE I
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T',I l'1lii- ll I t,l IJT E::l:
Tdrl'lli I Lr:il:[,
If cr+'..
{irtlt
ORI}ER HO,8185
{l'
r r llottt
ilAETEX SUPPLY BUL!( PLAtlrr ?oo souTH UtlrvERsrrY AvE, PROVO, UTAII
Thl.! l. r hlgh l.val talt sonduotcd rt 135r, rlth I 2-x o.llbr.tlon.
Grrd. lav.l ir t37', octnurcd to tha top of the ftll pi.pr'
IEATHER t hot end aunnY
i[ lnlIii:[IT
T&:4P6rt 4r,, n
F;.I-.'T:-.'":J
rrPra.rl .rc.J-
UEtl e c ',
I
t--l:::-:::i:::::-lI--13-r-iI:I::-l--::f:-::11-11---'-t-?--1T:::--------------1
/lr=5
Ruoelrtrd Envlronnrntrl Byrtmtq Ine.
TAIIK RESULTS
Iork Ordr tlo. t Af6S
{{55S70()Et3(,3
SALT LArE CrrY , UT e4l07
I -800-333-2379
Detr r
Gallone r
7 /9t9o
tor
Trnkr I
TLnc r 13t22
Tank Dlenctcrr
Trshnicl.rn r
Produott
961 Ground tlrter
uTot2t
DSL
Lcvelr 1O' +/-
Deta
Celtbretion t
Anount Urcdt O. lO
Bardlng Zonr Start 575
Lcvol Scgrrnt Frort t
Trnp Scgrtnt Fronr IVolunrr IOOOO
Produot Lrvolt 133.Ofatrr Lcvrlt O. O
Spcolfto Brrvltyt O. 752OtX)
Cocf,floLrnt Of Expen;ionr
Tenk Dlurtrr t 96. O
to
to
to
o. ()()()6519
580
374
374
Reaulta
Changr In Crllbrltton Zonc
Callbrrtton Unlt(gel/unlt )
Totel Chengr(gph, !
Tcnpcreturr Effrot(gph)llrt Ghrngt ( gph ) r
r 2lAr O.000{6
Strrting Trnp*rturr(F) r 8O.93
Hred Prmlurc(ool/ln (Btnl) . lOl.52
Surfeoc Aru(rq. Ln) . 10.57
-o. 0430{r -O.()67()l
o.9l_39?
AEg / Elrcrekrna,rr
talt r ?oo r l- { ,rtr Pree l- s l- r=rr l-eal< 'T.eEt
!tltf GtrY ' Ut tatOn l-aOO-lll-ll?t
I TechnLol.en UTOlzl I CallbratLon Value ;.q UIIITS 7og* Glal. I
I Date 7l9l9o I Syatern VarLatlon I UNITS I GPH I
I Tlme Startad 13t22 I IIIBH LEVEL ( FULL SYSTE}I } I g I ,ol? !
I Ballona 10K I LOU LEVELil TIID LEVELil I
I Tank Dl.ameiter 96i I PRODUCT LIIIE
I Eround llater lO'+/- I TEST IS rtpasseo ( )FATLED ( )rlrcoxcLusrvE r
JI TEST COIIDUCTED AT Itl IllCHEs I 6RADE LEVEL AT /]3 IICHES
nios
!}irilr
rl*'!H.
rlt Ii:,
s{$
nrH:
:ll:rM
il'I f.l[i* l.1lt l.,ll..l'ill'lf :ii:
t,[lfilt.l]l.ri lii; ,li: liiltlii
'!hl;i:l
F0CU5 S,trS L/ l,OO T ORI}ER HO , STBS
rr llotes
}IAETEX SUPPLY BULI( PLAIIT, 7OO SOUTH UIIVERSITY AYE, PROYO, UTAII
Thte lg a hlgh leval teet conducted at l4lr, vlth a 2-X and
a rLser. Eradc level Le 133r, metsured to the top of the fttl plpe.
IEATHERT hot end eunny
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>tr
lZobttcf
LWEL 4
C:*t-
rFrrry ,( \'1L
TlFalPch,+roaF
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I
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Rlroclrtrd Envlnonmrntrl Byrtrmrl InE.
TA}II( RESULTS
445sS7(x)E*303
SALT LArE CITY , UT.84tO7
1 -800-333-2379
TcohnLcLenI UTOl2t
Productr REG
95r Ground Irtor Levclr lO'+l-
Iorh Ordu tlo. r
Drtr t 7l9l$
Gallongt IOK
81st Tank r
TLnc r
Tenk
2
L3t22
Diameter r
Deta
Cellbretlonr
Anount Urcdr O. lO
RredLng Zonr Stert 260 to 266Lcvcl Bcgrrnt Frorr 267 to 599
Tenp Scgrtnt Frotr I to 599Yoluncr IOOOO
Product Lrvrlt 1{1.OUrtrr Lovrlr O. OSpeclllo Brrvttyt O.72IOOOCorflLoLut Of ExpentLonr O.OOO6glt
Tank DLe;ottrr l.O
Reaultg
Ghango In Grltbrrtion ZonaCrllbrrtlon Unlt (gel/unlt )
Totrl Ghengr(gph) r
Tcnpereturc Ef,lrot(gph)tlct Chengr(gph) r
. 118r o.00063
StertLng Trnptmturr(F) r 72.ALHlld Prlmurl(ool/ln (Btnl) r 1O2.OB
Surfeoa Arlt(rq. ln) r 2O,2A
-o. o1280r -O. Oa3,lt
o. ()3()61
I i!!aa lt!t!
.AEEI / Brecrkrlrrr PrceA=aor-r ^serrc T=ataalt I tao a a tC ta!l Lata olll . lt aalot t-aCo-trl-al?a
I Tcohnlolrn UTOI21 I Clllbrrtl.on Vrlu! 7y UIIITS zo.(Gal. I
I Drte 7l t2l90 I Sylten V.rirtlon I UilTTS I GPH I
I Tlnr Strrtrd lgt0l I HIGH LEVEL (FULL SYSTEII) I
I Gellonr loN I LOr LEVEL( ) tttD LEYEL(Irl t{ | ,o!- |
I T.nk DLenetar 96'I PRODUCT LITIE
I Ground llatlr LO'+I- I TEST IS (hPASSED (
'FAILED
()IIICOICLUSIVE I
ril
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TS:s $s
TrHE*t'tIr.{uTH5
f*t{}:H Uf.lL
trs
FOCUS l.EO L/ 1.OO T
r r llotar
IIAETEX SUPPLT BULTI PLAIIT, 7OO SOUTH UITIVENSITY AYE, PROYO UTAH
Thlg 1. . rld l.vet te.t oonduotrd .t l2{tr rtth .r l-X olllbrltLon.
Errdc l.v.L,, l3,lr, rlrrurod to the top of th. flll plp..
UEATHERT nJ.ght, rarn tnd oeln
fB.r.{^ qlr4 r.rI e
TTI:
tfft-il
I r,,,1
U'-4\I\'.
{
..re.L--l[ q]r 1,rpi.ffi-
LCy' tL .t
I I
l--::::-::I3:::::-l:--::-Y-lT:::-1--:Y:-::I1-lI---t:-v--lT:::--------------l
onrlEn Ho,8185G
IT
,o
Ar;oelltrd Envirormrntrl Bystrmlr; IrrE-
TA}II( RESULTS
a{55S7(xrEr3(,3
EALT LAT(E CITY , UT AIIOT
I -800-333-?,379
Trahnlolenr UTOl2l
Produot r UllL
96r Bround Urtcr Lrvolr 1O'+l-
/n=5
J
Uork
Drtrr
Ordrr llo. t 8t858 Trnkt 2
Tlnr r 19 t0l
?rnk Dlurter rBrllonr r
7 t t2t90
lotl
CrllbrrtLont
Anount Urrd t O. 05
Rcrdlne Zont Btrrt 58 to 5t
Lcv:l Sogrent Frort 7J to 599
Trnp Srgrrnt Frort 3fZ to 399Yolurrr lfirOO
Produot LtvrLt l2l.OIrtr Lrvrlt O. O
Epool,flo Brtvttyt O.?l3odlCorlflolrnt Of Erprnrionr O.OOO7O25
Trnk DLmrtrri 96. O
Deta
RffUlte lr.!!r !r-EtrrrrrtlrEltt!ttraatla.=tr tr
Ghrngr In Crllbrttion ZonrCrllbntton Unlt(gtl/unlt!
Totrl Chrngr(gBh, I
?orpcretur. Etfrot( gph )tlet Ghrngr(gph, .
I
-o. 05003. -O. Of3Ol
-o. 03503
t8
o. oo278!
Btutlng Tmportturr(Fl r 76. 08
Hred Prtrurc(ool/ln (Btrl ) : 88. {l
Surf,ror Arm(rg. tnt r 67.5O
AES / Elr(3ekmarr Pree{gl-t=rr l-taak'T.r=gt
aaat a ?OC t a lOt laLf LaIl Et?r r Ut lalOt t-loO-tll-tl?t
l--:::::i:i::---:::l:1-- -----l--::ii::::i::-::1::--l-?-:IT---I-::l!ll:--l
I Datc ?llzlg0 I Syaten Varlatton I UIIITS I 6Pll I
I Tlnc Stert;d 16t25 I HI6H LEVEL (FULL SYSTEII) I lof, I -,r?). 1
I Gallonr 1()K
,I Tenlt Dlenetcr 96i I PRODUCT LI]IE
I Bround lletcr LO,+I - I TEST IS OPASSED ffnrrueo ( )rilcottcLusrvE r
13-r,-IL?I TEST COIIDUCTED AT IllCHEs I GRADE LEVEL AT 133 IIICHES
ur$
Hfi
:xl H::
S#l
nrxi:
:i:ff 'futilt
T I r.l H,* [.1 I r,l ilT l[ :i
T'rllfdl:l L :ii:tl:h
FOC U5 I .5S L./ I .0S T ORI}ER HO . STASE
rr tlotu
IIAETEX SUPPLY BULI( PLAIIT, 7OO SOUTH UIIIYERSITY AVE, PROVO, UTAH
Thl; 1g e hlgh levrl teat rterted at L32', endlng at L29'. Tro
l-X caltbratlon; rGrG addad durlng the teet. Girade level ls 133r,
neasured to thc top of, thc fllt plpe.
IEATHERI nLghtr rtri end erln
9.tr:
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tt p/eoD trel-
tf,Veu
ft;rrlun 'trJl
lX <-+L
hrfa-..rr1;, rt{
tY4t
I .LOT LEVEL( ' IIID LEYELil I I
I II
I
I
Aroclrtrd Envlrorynrnttl Eyttrmir Inc-
TAIIX BESULTS
a{558700E13(,3
SALT LA!(E CrTI , UT 8{lO7
l-800-333-2a79
TrohnLcl.anr UTOI2t
Productr BUL
96t Ground U.tcr L.v.t t lO'+l-
/fii5
Iork Ordr llor r 8t85E
Drtor 7ll2l9D
B.Ilon.t loll
Trnk! t
Tlnrr 16t23
Tank Dlultor r
Totrl Ch.ngo(gph, .
Teip.frturo Etloot (gph I
ll.t Ch.ng.(gph, r
D!tr
raaaarrtaa-aaaaaaaaaaaatrllaaa-aaa ROfUltf "-ltrr'itlt'l'i"t!llirl"'-lr-tr:"
-o.29!43. -O. Ol89t
-o.2764e
Ch.ng. In Crllbrltlon Zono r 26
Grllbretlon Unlt(gel/unltl r O. Ool92
Et.rtlng TarPor.tur.( F, . 47.39ll..d Pror.or.(6oll1n (Et.r, r 91.98
Burt.or Aror(rqi tn, . a5.73
o
Crllbr.tlon t
Arount Uredt O. 05
Rordlng Zono Etrrt 334 to 3aO
L.e.t Begrtnt Frort 3al to 199
T.rp grg..nt Fro. t I to 59:,
Yolur.t IOOOO
Produot L.ealt L29,OXrtrr Lrvrlt O.O
Epeollto Orrvltrt o.7l3ooo
Coottlolont Ot Erp.Etlon t O. OOO7O25
Tenh Dlmrtorr 96. O
]
. AEEi./ Elror=katar-r Pre<=l-gl-crrr 4-eak T.oat
aalt a ,ac I a r atl. ttlr !ttt i Ur aato t-tao-ttl-atrt
I . Technlolrn UTOlzt I Crllbratlon Yalue ?, f UtlITS ,of Gal. I
I Detr 7ll2l9i I Syatan Vrrlatlon I UIrTS r GPH r
I Tlne Startrd 2Or2O I HIGH LEVEL (FULL SYSTEII} I
I Eellonr ror I LOtl LEVEL(() IiID LEYEL( ,I 3 | -,o>- I
I Tenk DLenctcr 95r I PRODUCT LITIE
I Ground f,rtcr Lo'+/- I TEST Is (./nrsseo oFAILED ()IIICOIICLUSIYE I
I TEST COIIDUCTED AT 1o1 lllcllEs I GRADE LEVEL AT /]3 IxcHEs
nrs:
r$
l#{It
m fi:S
T',X t,1 H- t,t I t.,lt.l':ll H:n:
lr$t.llr: * *:tJ:t,,
,[r{l
FOCUS l.SO L/ 1.OO T onDER HO.8l85H
. r llot.r
TAETEX SUPPLT BUL!( PLAllT, 7OO SOt Ttl ullrYEBsrTY AVE, PROVO, UTAH
Thi! it e lor hvrl trlt oonduatrd et tol r, rLth . 2-X ctlibrgtlon'
Br.d. l.v.l 1' 133rr rcuurtd to the top of, the flll ptpr.
UEA?HERr nLghtr run tnd orln
-,rhilanra
i[ l''lIX:tl: 1:T
Au-r
tlA-a\v4L
T,,PPo
L6
FE-rt D 6A,i )'.At
rrf
I I
I I
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Arrsoelat;d Envlnonmrntel Elystcmrl It'tc.
TANK RESULTS
J
a{55S7008t3()3'
SALT LAKE CITY , UT 8,4IO7
1-eoo-333-2379
Iork Ordtr llor t et65H
Detr t 7l l2l9O
Eellonet tOK
Tenkr I
Tlnc t 2Ot2O
Tank DLenrtrt
Trohnlolrnt
Produotr
96t Ground Urter
uTol2l
SUL
Lrrvelr lO' +/-
Crtt brrtLon t
Anount Urrd t O. lO
Rradtrng Zont Etut 79 to 85
Lovcl Scgrrnt Frort 27O to 599
Tonp Ergnrnt Frort 27O to 55O
Yolurrt loff)O
Produot L;volt l0l.OXrtr Lcvrlt O. Ogpcolfto Brtvlty t O. 713(X)O
Corfficl.ont Of Exprnrlont O.OOO7O25
Trnk Dllrttrr r 96. O
Datf !ra!!==t!arara!!cE=t-tt!EaaEaEt:-rt3lBEtE
Raault;
Chengo In CrltbrttLon Zonc
Crltbrrtlon Unlt ( grl/unlt )
Sterttng Tmprrrturr(F) ! 86.
Hred Prrllurr(ool/ln (Btr! ) I
Surlror Arrt(rq. ln) r 142.93
rl?
r O.OO588
97
72. OL
Totrl Chtngr(gPht i
Tcrprlrrturt Eft.ot(gph)llrt Chrngr(gph, r
a
o. ol9{{
-o. oo125
o. 02069
taarrarial
.':i '
(
(
{r
ilii 1
PEITY IJ.
'
PREVIOUS POLLUTION INCIDENTS
Mr. Dennis Downs
Executive Secretary
Utah Solid & Hazardous Wasres Cormittee
Dear Mr. Downs:
As required by paragraph 26-L4e4O4 of
performed a tanl and line tightness test on
and based on this test there has not been
on "customary business inven tory practices
petroleum from my
the Underground Storage Tank Act, I have
eachlndergr-ound storage tank at my facility,
a release of petroleum. Additionally, based
standards", I am not aware of any. release of
To:
srSna tor
AB,
I have had the following releases of petroleum (detailed below; also mention any actionyou took to clean up the release).
-
slgnature ot owner/operator
Tank Fund.